Alicia G Bradshaw, MS, MFTI

Individual provider Active NPI Marriage & Family Therapist · Chattanooga, TN

NPI 1053944397 · NPPES record last updated Feb 14, 2020

Key facts

NPI
1053944397
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1511 (TN)
Practice address
7111 Lee Hwy
Chattanooga, TN 37421-6706
Phone
(423) 402-8256
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1511TNMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1511 TN Yes

Addresses

Primary practice location

7111 Lee Hwy
Chattanooga, TN 37421-6706

Mailing address

204 Brookwood Dr
Chattanooga, TN 37411-1803
Phone (423) 402-8256

Other practice location 1

930 Ashland Ter
Chattanooga, TN 37415-3554
Phone (423) 402-8256

Other names

  • Ms. Alicia N Garcia Former name

Other providers in Chattanooga, TN

All providers in Chattanooga, TN · Marriage & Family Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.