Provider Information for 1043052160
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CRAIG BRAY MFT
Sex: Male
NPI: 1043052160
Last Updated: 2024-06-10
Certification Date: 2024-06-10
Certification Date: 2024-06-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1043052160 | ||||||||
| Enumeration Date | 2024-06-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 16195 LAGUNA ST VICTORVILLE, CA 92395-0600 United States Phone: 909-222-0594 | Fax: | ||||||||
| Primary Practice Address | 16195 LAGUNA ST VICTORVILLE, CA 92395-0600 United States Phone: 909-222-0594 | Fax: | ||||||||
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