Provider Demographics
NPI:1770992489
Name:BRAY, DWAN LAKRESIA
Entity type:Individual
Prefix:
First Name:DWAN
Middle Name:LAKRESIA
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 1:5406 KINGSWAY CT W
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-5109
Mailing Address - Country:US
Mailing Address - Phone:513-593-1332
Mailing Address - Fax:
Practice Address - Street 1:5406 KINGSWAY CT W
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-5109
Practice Address - Country:US
Practice Address - Phone:513-593-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula