Provider Demographics
NPI:1285485045
Name:RAY, AZIA
Entity type:Individual
Prefix:
First Name:AZIA
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 OLD FIRE TOWER RD APT 1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8075
Mailing Address - Country:US
Mailing Address - Phone:252-408-7433
Mailing Address - Fax:
Practice Address - Street 1:2080 OLD FIRE TOWER RD APT 1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-8075
Practice Address - Country:US
Practice Address - Phone:252-408-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician