Provider Demographics
NPI:1962250431
Name:CRAY, SHELLEY B
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:B
Last Name:CRAY
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 1:13122 WALTONS TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-3056
Mailing Address - Country:US
Mailing Address - Phone:804-749-4222
Mailing Address - Fax:
Practice Address - Street 1:13122 WALTONS TAVERN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-3056
Practice Address - Country:US
Practice Address - Phone:804-749-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPGP-506709101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool