IndividualActive
Bradley Shaw
NPI 1104229871 · Professional Counselor · Bryant, AR
Provider details
- NPI number
- 1104229871
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- P0002005 (AR)
Mailing address
3708 Robinwood Cir
Bryant, AR 72022-8374
Registry dates
- Enumerated
- 2014-10-08
- Last updated
- 2014-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.