Individual
DEJRAH MONIQUE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
21697
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588706048
—
OK
Enumeration date
03/09/2021
Last updated
06/19/2026
Update your record
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