Bray, Stacy Ann

Bray, Stacy Ann is an individual health care provider with primary practice located at 2702 Cunningham Ave Ste A, Joplin MO 64804-1570. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bray, Stacy Ann can be contacted via phone (417) 782-1910.

Contact Information

Primary practice address
2702 Cunningham Ave Ste A Joplin MO 64804-1570
Fax: (417) 782-1844
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2005004515 Missouri

Profile Details

NPI number 1689668345
LBN Legal business name Bray, Stacy Ann
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Apr 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689668345 NPPES
Kansas MEDICAID 200972540A
Kansas MEDICAID 1689668345
Kansas Other 1366779100

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