Provider Demographics
NPI:1669102810
Name:BRAY, VANESSA LEANNE (BSW, MSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:LEANNE
Last Name:BRAY
Suffix:
Gender:F
Credentials:BSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-1717
Mailing Address - Country:US
Mailing Address - Phone:214-206-7202
Mailing Address - Fax:
Practice Address - Street 1:106 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1928
Practice Address - Country:US
Practice Address - Phone:214-206-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty