Individual
MRS. CRYSTAL ANN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 713-4500
(336) 713-4501
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2420
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107303
—
NC
Enumeration date
09/13/2006
Last updated
03/21/2023
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