Individual
MR. EDWARD G BRADLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
223 N 3RD ST, SUITE 104, MUSKOGEE, OK 74401-6609
(918) 682-7797
(918) 686-8881
Mailing address
223 N 3RD ST, SUITE 104, MUSKOGEE, OK 74401-6609
(918) 682-7797
(918) 686-8881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
478
OK
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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