Individual
JENNIFER BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 HAWTHORNE DR, MIDWEST CITY, OK 73110-7614
(405) 474-9992
Mailing address
1105 HAWTHORNE DR, MIDWEST CITY, OK 73110-7614
(405) 474-9992
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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