Individual
MISS TRACI ANN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
2200 N SECTION ST, SULLIVAN, IN 47882-7523
(812) 268-4311
(812) 268-2648
Mailing address
11388 LAKE RD, TERRE HAUTE, IN 47802-8437
(812) 894-2205
(812) 894-2205
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
864188
IN
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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