Provider Demographics
NPI:1699929547
Name:BRAY, KIMBERLY ANN (BCBA)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:BRAY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1759
Mailing Address - Street 2:DEPT. 952
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77251-1759
Mailing Address - Country:US
Mailing Address - Phone:713-554-5304
Mailing Address - Fax:713-554-5320
Practice Address - Street 1:2075 MEADOWLANE AVE
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-4951
Practice Address - Country:US
Practice Address - Phone:321-724-4482
Practice Address - Fax:321-757-5177
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst