| Stanley Richard Ray, Ph.d., Pc | |
|
2214 W 12th Ave Stillwater OK 74074-5127 | |
| (405) 743-1181 | |
| (405) 743-1181 |
| Full Name | Stanley Richard Ray, Ph.d., Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2214 W 12th Ave, Stillwater, Oklahoma |
| Authorized Official Name and Position | Stanley Richard Ray (COUNSELING PSYCHOLOGIST) |
| Authorized Official Contact | 4057431181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanley Richard Ray, Ph.d., Pc 2214 W 12th Ave Stillwater OK 74074-5127 Ph: (405) 743-1181 | Stanley Richard Ray, Ph.d., Pc 2214 W 12th Ave Stillwater OK 74074-5127 Ph: (405) 743-1181 |
| NPI Number | 1750693347 |
|---|---|
| Provider Enumeration Date | 07/12/2010 |
| Last Update Date | 07/12/2010 |
| Medicare PECOS PAC ID | 7113051285 |
|---|---|
| Medicare Enrollment ID | O20100812000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750693347 | NPI | - | NPPES |
| 100839750A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 337 (Oklahoma) | Primary |
| Provider Name | Stanley R Ray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003865163 PECOS PAC ID: 0840324026 Enrollment ID: I20100811000056 |
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