Provider Demographics
NPI:1689791154
Name:RAY, WANDA F (TLMLP)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:F
Last Name:RAY
Suffix:
Gender:F
Credentials:TLMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9265 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3138
Mailing Address - Country:US
Mailing Address - Phone:913-406-3611
Mailing Address - Fax:
Practice Address - Street 1:13830 SANTA FE TRAIL DR
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3310
Practice Address - Country:US
Practice Address - Phone:913-492-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTLMLP1032103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling