Individual
DR. STACY ANN BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2702 CUNNINGHAM AVE, STE A, JOPLIN, MO 64804-1570
(417) 782-1910
(417) 782-1844
Mailing address
2702 CUNNINGHAM AVE, STE A, JOPLIN, MO 64804-1570
(417) 782-1910
(417) 782-1844
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2005004515
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366779100
GREATER OZARKS RURAL PSYCHOLOGISTS
MO
05
—
1689668345
—
MO
05
—
200972540A
—
KS
Enumeration date
09/08/2005
Last updated
04/11/2014
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