Provider Demographics
NPI:1295839538
Name:BRADEN, SHARON E (PHD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:BRADEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 1/2 SW FRANK PHILLIPS
Mailing Address - Street 2:ROOM 4
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003
Mailing Address - Country:US
Mailing Address - Phone:918-336-1234
Mailing Address - Fax:918-336-7604
Practice Address - Street 1:102 1/2 SW FRANK PHILLIPS
Practice Address - Street 2:ROOM 4
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003
Practice Address - Country:US
Practice Address - Phone:918-336-1234
Practice Address - Fax:918-336-7604
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional