Provider Demographics
NPI:1821469123
Name:BRAY, ALLISON COVILLE (PHD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:COVILLE
Last Name:BRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 WALTER REED DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1114
Mailing Address - Country:US
Mailing Address - Phone:336-547-1574
Mailing Address - Fax:336-323-5247
Practice Address - Street 1:606 WALTER REED DR
Practice Address - Street 2:SUITE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1114
Practice Address - Country:US
Practice Address - Phone:336-547-1574
Practice Address - Fax:336-323-5247
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical