Individual
DR. DONALD RAY BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., PH.D., D.MIN.
Contact information
Practice address
1934 NW COPPER OAKS CIR, SUITE A, BLUE SPRINGS, MO 64015-8300
(913) 345-0033
Mailing address
1934 NW COPPER OAKS CIR, BLUE SPRINGS, MO 64015-8300
(913) 345-0033
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY01609
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1771001
MEDICARE PTAN
MO
Enumeration date
03/12/2007
Last updated
12/30/2016
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