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General NPI Number Information
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NPI Number | 1023577384
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Entity Type | Individual
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Provider Name | KACIA KRISTIN MCCAGHREN BRAY PH.D., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2019
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 301 MAGG SMITH RD
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-5904
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Country | US
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Telephone | 850-516-4037
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MAGG SMITH RD
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-5904
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Country | US
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Telephone | 850-516-4037
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TPSA608
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9067
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP013686
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7870
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License Number State | NC
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