Individual
KAREN LYNN RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC, LPC
Contact information
Practice address
2111 E BASELINE RD STE E3, TEMPE, AZ 85283-1518
(480) 296-3606
Mailing address
2111 E BASELINE RD STE E3, TEMPE, AZ 85283-1518
(480) 296-3606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-17172
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YP2500X
TAXONOMY CODE
AZ
01
—
14223751
CAQH CIGNA PROVIDER ID
AZ
Enumeration date
05/25/2018
Last updated
06/16/2018
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