Individual
DEJRAH MONIQUE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
Mailing address
PO BOX 1581, BROKEN ARROW, OK 74013-1581
(918) 402-8723
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588706048
—
OK
Enumeration date
03/09/2021
Last updated
03/09/2021
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