Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 337 | OK |
NPI | 1003865163 |
---|---|
Provider Name | Dr. Stanley Richard Ray |
First Address | Stillwater, OK 74074-5127 |
Second Address | Stillwater, OK 74074-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/07/2007 |