Individual provider · Type 1 NPI

Bradley Dewayne Clark

Peer Specialist · Tulsa, OK

NPI number 1457008955 Active

Practice location

252 W 17th Pl
Tulsa, OK 74119-4654

Call (918) 200-9065 Map

Fax (918) 585-9543

Mailing address

1620 S Elwood Ave Apt L3
Tulsa, OK 74119-4252

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1457008955

Bradley Dewayne Clark's National Provider Identifier is 1457008955, issued on Mar 4, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Tulsa, OK. The record was last updated on Mar 4, 2022.