Provider Demographics
NPI:1740908144
Name:RAY, CRYSTAL (LMFT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-5115
Mailing Address - Country:US
Mailing Address - Phone:469-971-8085
Mailing Address - Fax:
Practice Address - Street 1:1715 LAUREL RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-5115
Practice Address - Country:US
Practice Address - Phone:469-971-8085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist