Individual
COURTNEY LAUREN RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1711 N LYNHURST DR, SPEEDWAY, IN 46224-5501
(317) 250-1151
Mailing address
1711 N LYNHURST DR, SPEEDWAY, IN 46224-5501
(317) 250-1151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004092A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200735890A
—
IN
Enumeration date
05/15/2007
Last updated
11/22/2009
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