Provider Demographics
NPI:1528350147
Name:WRAY, ERIN MACKENZIE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MACKENZIE
Last Name:WRAY
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 1:232 WOODMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-5697
Mailing Address - Country:US
Mailing Address - Phone:540-493-7112
Mailing Address - Fax:
Practice Address - Street 1:232 WOODMAN RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-5697
Practice Address - Country:US
Practice Address - Phone:540-493-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist