Provider Demographics
NPI:1336171750
Name:RAY, JOANNE WHITE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:WHITE
Last Name:RAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242301
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2301
Mailing Address - Country:US
Mailing Address - Phone:334-834-2488
Mailing Address - Fax:334-215-4532
Practice Address - Street 1:8650 MINNIE BROWN RD
Practice Address - Street 2:STE 14
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-834-2488
Practice Address - Fax:334-215-4532
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL834103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51001049OtherBCBS
S81494Medicare UPIN