Provider Demographics
NPI:1790362267
Name:BRAY, JAIMI L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JAIMI
Middle Name:L
Last Name:BRAY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 NILES AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1615
Mailing Address - Country:US
Mailing Address - Phone:269-982-7200
Mailing Address - Fax:269-982-0202
Practice Address - Street 1:1901 NILES AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1615
Practice Address - Country:US
Practice Address - Phone:269-982-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor