Provider Demographics
NPI:1932747979
Name:WRAY, WENONA NEPHTA-LI (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:WENONA
Middle Name:NEPHTA-LI
Last Name:WRAY
Suffix:
Gender:F
Credentials:LPC, NCC
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 251
Mailing Address - Street 2:
Mailing Address - City:NATALIA
Mailing Address - State:TX
Mailing Address - Zip Code:78059-0251
Mailing Address - Country:US
Mailing Address - Phone:313-434-1933
Mailing Address - Fax:
Practice Address - Street 1:977 COUNTY ROAD 6711 STE 3
Practice Address - Street 2:
Practice Address - City:NATALIA
Practice Address - State:TX
Practice Address - Zip Code:78059-2640
Practice Address - Country:US
Practice Address - Phone:830-772-6009
Practice Address - Fax:830-772-6019
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-19
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79763101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX448289501Medicaid