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1801554779
SAGE BRADLEY SHAW
OTTAWA, KS
NPI
1801554779
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: KS 03100-T)
Enumeration Date
2021-12-07
Last Update Date
2021-12-07
Business Address
SAGE BRADLEY SHAW LMLP-T
109 W 2ND ST STE A
OTTAWA, KS 66067-2212
Phone number: 785-242-2991
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Mailing Address
SAGE BRADLEY SHAW LMLP-T
1953 RENO RD
OTTAWA, KS 66067-8754
Phone number: 785-214-9338
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