Most Relevant Information
Provider Data
| NPI Number: | 1003249830 |
| Provider Name: | TIERRA BRADDEN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 1578690137 |
Most Important Dates
| Enumeration Date: | 08/15/2013 |
| Last Updated: | 08/15/2013 |
Provider Practice Location
3621 N KELLEY AVE STE 100
OKLAHOMA CITY
OK
731114520
Practice Location Phone/Fax
| Phone: | 4055254425 |
| Fax: |
Provider Mailing Location
5417 S HUDDLESTON DR
OKLAHOMA CITY
OK
731352321
Provider Mailing Phone/Fax
| Phone: | 4058386386 |
| Fax: |