Individual
MS. MARY L BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1502S BOULDER AVE 22H, TULSA, OK 74119-4027
(918) 745-2236
(918) 392-5969
Mailing address
1502S BOULDER AVE 22H, TULSA, OK 74119-4027
(918) 745-2236
(918) 392-5969
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1156
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156
STATE LICENSE
OK
Enumeration date
06/14/2006
Last updated
08/22/2015
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