Provider Demographics
NPI:1114196573
Name:RAY, TONYA D (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:D
Last Name:RAY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7589 HIGHWAY 51
Mailing Address - Street 2:
Mailing Address - City:NEW BROCKTON
Mailing Address - State:AL
Mailing Address - Zip Code:36351-8277
Mailing Address - Country:US
Mailing Address - Phone:334-477-6183
Mailing Address - Fax:334-894-9029
Practice Address - Street 1:611 GLOVER AVE
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2057
Practice Address - Country:US
Practice Address - Phone:334-477-6183
Practice Address - Fax:334-894-9029
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist