Provider Demographics
NPI:1629468301
Name:RAY, ANNA NEELEY (OTA)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:NEELEY
Last Name:RAY
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 16011
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6700
Mailing Address - Country:US
Mailing Address - Phone:870-933-9294
Mailing Address - Fax:870-933-9293
Practice Address - Street 1:3114 FOX RD
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9322
Practice Address - Country:US
Practice Address - Phone:870-933-9294
Practice Address - Fax:870-933-9293
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant