Individual
MRS. MARIE ELENA BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
51 N MAIN STREET, STE 1A, SOUTHINGTON, CT 06489
(860) 637-0947
(860) 276-8670
Mailing address
130 DUNHAM STREET, SOUTHINGTON, CT 06489
(860) 637-0947
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000795
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292739
MHN
CT
01
—
410000795CT04
ANTHEM
CT
01
—
7470464
AETNA
CT
Enumeration date
09/08/2006
Last updated
07/09/2007
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