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Individual

MRS. JILLIAN DIANE WRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
1903 S HAWTHORNE RD, WINSTON SALEM, NC 27103-3916
(336) 718-6700
Mailing address
PO BOX 601791, CHARLOTTE, NC 28260-1791

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8182
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8182
STATE LICENSE #
NC
Enumeration date
02/06/2012
Last updated
04/08/2026
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