Individual
MINNIE J BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
3303 FREDERICK AVE, SAINT JOSEPH, MO 64506-2985
(816) 364-3836
(816) 390-8546
Mailing address
2966 SE IRWIN RD, CAMERON, MO 64429-9348
(816) 449-5359
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2003024605
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33092012
BLUE CROSS BLUE SHIELD
MO
Enumeration date
08/31/2006
Last updated
07/08/2007
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