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Individual

DONNA BRADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
205 E POPLAR ST, FORT GIBSON, OK 74434-8272
(918) 478-2456
Mailing address
23504 N 534 RD, TAHLEQUAH, OK 74464-2178
(918) 207-2197

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1769
OK

Other

Enumeration date
09/14/2018
Last updated
09/14/2018
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