Individual
DIANA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
117 N MAIN ST, SAND SPRINGS, OK 74063-7602
(918) 308-9847
Mailing address
PO BOX 700, SAND SPRINGS, OK 74063-0700
(918) 671-9932
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3011
OK
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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