Provider Demographics
NPI:1467628669
Name:RAY, BETHANY MICHELLE (COTA)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:MICHELLE
Last Name:RAY
Suffix:
Gender:F
Credentials:COTA
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Mailing Address - Street 1:1403 MILL RACE LANE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-444-0526
Mailing Address - Fax:540-444-0531
Practice Address - Street 1:342 VIRGINIA AVENUE
Practice Address - Street 2:HEARTLAND REHABILITATIONSERVICES OF VIRGINIA-WYTHEVILLE
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:276-228-6200
Practice Address - Fax:276-228-9175
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
1071873224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant