Healthcare Provider Details

I. General information

NPI: 1881517233
Provider Name (Legal Business Name): DAJONAE JASEANA BRADLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 W CAPITOL DR STE 105
BROOKFIELD WI
53005-2661
US

IV. Provider business mailing address

15400 W CAPITOL DR STE 105
BROOKFIELD WI
53005-2661
US

V. Phone/Fax

Practice location:
  • Phone: 414-367-9155
  • Fax: 414-600-9080
Mailing address:
  • Phone: 414-367-9155
  • Fax: 414-600-9080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: