Organization
AMY RAY, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY LEANDRA RAY PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(815) 553-0788
Entity
Organization
Contact information
Practice address
350 HOUBOLT RD, SUITE 202, JOLIET, IL 60431-8305
(815) 553-0788
(815) 553-0789
Mailing address
507 BIRCH DR, SHOREWOOD, IL 60404-9740
(815) 553-0788
(815) 553-0789
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071005955
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225368228
NPI
IL
Enumeration date
06/01/2011
Last updated
06/01/2011
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