Provider Demographics
NPI:1376236901
Name:BRAY, NATALYA KALINA (LMT)
Entity Type:Individual
Prefix:MS
First Name:NATALYA
Middle Name:KALINA
Last Name:BRAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BROMLEY VILLAGE DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7036
Mailing Address - Country:US
Mailing Address - Phone:980-748-7910
Mailing Address - Fax:
Practice Address - Street 1:153 BROMLEY VILLAGE DR UNIT 102
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7036
Practice Address - Country:US
Practice Address - Phone:980-748-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13262225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist