Provider Demographics
NPI:1982958260
Name:RAY, KILYNDA VERNETTE (PHD)
Entity Type:Individual
Prefix:
First Name:KILYNDA
Middle Name:VERNETTE
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 1:8550 W DESERT INN RD STE 102-343
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4401
Mailing Address - Country:US
Mailing Address - Phone:972-921-5490
Mailing Address - Fax:
Practice Address - Street 1:2300 RAMSEY STREET, BLDG. 50, RM 206
Practice Address - Street 2:VETERAN'S HEALTH ADMINISTRATION
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-6170
Practice Address - Country:US
Practice Address - Phone:702-768-2593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019871103T00000X
NC4589103T00000X
CA25246103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist