Individual
MISS DESIREE ANN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
607 S. 4TH STREET, PONCA CITY, OK 74601
(580) 762-1360
Mailing address
607 S 4TH ST, PONCA CITY, OK 74601-6336
(580) 762-1360
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3477
OK
Other
Enumeration date
12/14/2006
Last updated
01/04/2011
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