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General NPI Number Information
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NPI Number | 1316373285
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Entity Type | Individual
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Provider Name | DANETTE P BRAY LMHC, CAP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 1986 31ST AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-6628
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Country | US
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Telephone | 888-975-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 775 CARNATION DR
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City | SEBASTIAN
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State | FL
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Zip | 32958-4988
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Country | US
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Telephone | 401-207-4039
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC00572
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ACDP
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License Number State | RI
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