Individual
RAY TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
919 S 12TH ST, BISMARCK, ND 58504-5977
(701) 323-4000
Mailing address
128 SOO LINE DR, BISMARCK, ND 58501-3339
(701) 323-4000
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
6952
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1381005654
TRICARE
SD
Enumeration date
08/16/2016
Last updated
12/17/2025
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