Provider Demographics
NPI:1043791965
Name:RAY, RUTH ANN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANN
Last Name:RAY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:RUTH
Other - Middle Name:ANN
Other - Last Name:OLDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3811 QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-6219
Mailing Address - Country:US
Mailing Address - Phone:817-408-7928
Mailing Address - Fax:
Practice Address - Street 1:3811 QUAIL RUN
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-6219
Practice Address - Country:US
Practice Address - Phone:817-408-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant