Provider Demographics
NPI:1427945104
Name:BRAY, JODEAN HELEN
Entity type:Individual
Prefix:
First Name:JODEAN
Middle Name:HELEN
Last Name:BRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2077 COUNTY HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:BOVINA CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:13740
Mailing Address - Country:US
Mailing Address - Phone:607-435-5797
Mailing Address - Fax:
Practice Address - Street 1:2077 COUNTY HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:BOVINA CENTER
Practice Address - State:NY
Practice Address - Zip Code:13740
Practice Address - Country:US
Practice Address - Phone:607-435-5797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer