Provider Demographics
NPI:1194947705
Name:BRADSHER, SHERRY NEOMA
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:NEOMA
Last Name:BRADSHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 APACHE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371
Mailing Address - Country:US
Mailing Address - Phone:910-858-4242
Mailing Address - Fax:
Practice Address - Street 1:3423A MELROSE RD
Practice Address - Street 2:
Practice Address - City:FAYEVETTVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-864-8739
Practice Address - Fax:910-864-8222
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)