| Doctor Name: | THERESA T BRADSHAW |
| NPI Number: | 1356307086 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW LCSW |
| License Number: | CSW337 |
| Business Practice Address: | 910 East Railroad Fort Morgan, CO - 80701 |
| Business Phone Number: | 9708674924 |
| Business Fax Number: | 9708672695 |
| Mailing Address: | 211 West Main Street, STERLING |
| State: | CO |
| Postal Code: | 80751 |
| Phone Number: | 9705224549 |
| Fax Number: | 9705229544 |
| NPI Enumeration Date: | 04/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |