| Doctor Name: | SHIRLEY DIAN BRADSHAW |
| NPI Number: | 1679899744 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.H.C. |
| License Number: | MH 9333 |
| Business Practice Address: | 1127 S Patrick Dr #24 Satellite Bch, FL - 329373939 |
| Business Phone Number: | 3217731111 |
| Business Fax Number: | |
| Mailing Address: | 1127 S Patrick Dr, #24 SATELLITE BCH |
| State: | FL |
| Postal Code: | 329373939 |
| Phone Number: | 3217731111 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2010 |
| NPI Last Update Date: | 06/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH 9333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |