Individual
DR. KELLY PAULK RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, MP
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
MP.0862
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1474657
—
LA
Enumeration date
07/29/2005
Last updated
02/14/2019
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