Provider Demographics
NPI:1124846605
Name:RAY, DIANA MARIE (MHC-LP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:RAY
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 TEC DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-9593
Mailing Address - Country:US
Mailing Address - Phone:585-658-0900
Mailing Address - Fax:585-320-1099
Practice Address - Street 1:5712 TEC DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NY
Practice Address - Zip Code:14414-9593
Practice Address - Country:US
Practice Address - Phone:585-658-0900
Practice Address - Fax:585-320-1099
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health