Provider Demographics
NPI:1700139482
Name:RAY, ABBEY L (MHPP)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:L
Last Name:RAY
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:ALLENBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:307 E SEVIER ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3934
Mailing Address - Country:US
Mailing Address - Phone:501-315-4224
Mailing Address - Fax:501-778-0450
Practice Address - Street 1:307 E SEVIER ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3934
Practice Address - Country:US
Practice Address - Phone:501-315-4224
Practice Address - Fax:501-778-0450
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator