| NPI | 1770057309 |
|---|---|
| Former Name | MYNGOC BRADSHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 172V00000X Community Health Worker | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2025-10-14 |