Individual
KIMBERLY MYLES RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3905 FORD RD, SUITE 600, PHILADELPHIA, PA 19131-2824
(215) 220-2183
Mailing address
335 E ELM ST, CONSHOHOCKEN, PA 19428-1908
(773) 456-1677
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018397
PA
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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