Provider Demographics
NPI:1780892158
Name:LAY, PATSY RUTH (LBSW)
Entity type:Individual
Prefix:MS
First Name:PATSY
Middle Name:RUTH
Last Name:LAY
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 AMBER DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5406
Mailing Address - Country:US
Mailing Address - Phone:432-349-1842
Mailing Address - Fax:
Practice Address - Street 1:6435 AMBER DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5406
Practice Address - Country:US
Practice Address - Phone:432-349-1842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60373101YP2500X
TX23503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker