Individual
MARY C RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
4001 OFFICE COURT DR STE 102, SANTA FE, NM 87507-4903
(505) 983-8225
(505) 930-5427
Mailing address
4001 OFFICE COURT DR STE 102, SANTA FE, NM 87507-4903
(505) 983-8225
(505) 930-5427
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0158531
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
NM
Enumeration date
08/19/2019
Last updated
08/19/2019
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