Individual
TAMMY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 PARK PLACE AVE, # 110, FORT WORTH, TX 76110-1300
(817) 921-5020
Mailing address
1617 PARK PLACE AVE STE 110, FORT WORTH, TX 76110-1300
(817) 921-5020
(817) 921-5022
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209515
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
Enumeration date
06/25/2010
Last updated
07/13/2010
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