Provider Demographics
NPI:1619330644
Name:WRAY, BETH D'INVILLIERS
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:D'INVILLIERS
Last Name:WRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ENGLISH LN
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-2512
Mailing Address - Country:US
Mailing Address - Phone:609-457-7519
Mailing Address - Fax:
Practice Address - Street 1:312 E WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9565
Practice Address - Country:US
Practice Address - Phone:609-652-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO5936200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker