Individual
JENNIFER CORRINE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD/LD
Contact information
Practice address
4200 COPPER ROCK DR, EDMOND, OK 73025-2947
(405) 833-3891
Mailing address
4200 COPPER ROCK DR, EDMOND, OK 73025-2947
(405) 833-3891
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1626
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1626
LICENSED DIETITIAN
OK
01
—
997092
REGISTERED DIETITIAN
OK
Enumeration date
11/07/2008
Last updated
09/01/2015
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