Provider Demographics
NPI:1336290519
Name:BRADSHAW, EMILY ANNETTE (MHS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANNETTE
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:MHS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 NE 95TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2569
Mailing Address - Country:US
Mailing Address - Phone:816-420-8803
Mailing Address - Fax:
Practice Address - Street 1:1305 NE 95TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2569
Practice Address - Country:US
Practice Address - Phone:816-420-8803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOHE 104339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist