Provider Demographics
NPI:1023450442
Name:WRAY, ROXANNE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:MARIE
Last Name:WRAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 RURAL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLAYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15323-1338
Mailing Address - Country:US
Mailing Address - Phone:724-255-0085
Mailing Address - Fax:
Practice Address - Street 1:378 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4659
Practice Address - Country:US
Practice Address - Phone:724-229-2580
Practice Address - Fax:724-225-7798
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional