Most Relevant Information
Provider Data
| NPI Number: | 1003035254 |
| Provider Name: | CARRIE A RAY |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 178-002678 |
Most Important Dates
| Enumeration Date: | 04/25/2007 |
| Last Updated: | 09/10/2020 |
Provider Practice Location
151 N MAIN ST
DECATUR
IL
625231206
Practice Location Phone/Fax
| Phone: | 2173626262 |
| Fax: |
Provider Mailing Location
PO BOX 710
DECATUR
IL
625250710
Provider Mailing Phone/Fax
| Phone: | 2173626262 |
| Fax: |