Individual
TERESA RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32663 BUSH GARDEN DR, HARRISBURG, OR 97446-9751
(503) 388-0230
Mailing address
125 LOS SANTOS CT, VALLEJO, CA 94590-3521
(707) 246-9315
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
81-5344707
CA
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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