MEDICARE: MS. ADYSON PAIGE BRADLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor		OK

General Provider Information

NPI Number	:	1942172382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADYSON PAIGE BRADLEY

Provider Business Mailing Address
First Line	:	4200 PERIMETER CENTER DR STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2310
Country	:	US
Telephone Number	:	405-795-7526
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 PERIMETER CENTER DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2324
Country	:	US
Telephone Number	:	405-795-7526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	12/02/2025

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