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Individual

KAKA LYN RAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
5409 MARYLAND WAY STE 305, BRENTWOOD, TN 37027-1035
(615) 589-3879
Mailing address
6104 BRYAN PL, BRENTWOOD, TN 37027-4935
(615) 568-0784

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP2500X
Professional Counselor
Primary
0611
TN
101YP2500X
Professional Counselor
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
01/25/2018
Last updated
06/16/2018
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