Individual
HEATHER RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 12TH AVE NW, ARDMORE, OK 73401-5722
(580) 223-3411
(580) 226-6213
Mailing address
PO BOX 189, ARDMORE, OK 73402-0189
(580) 226-5048
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
09/26/2016
Last updated
03/02/2021
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