Healthcare Provider Details

I. General information

NPI: 1598629545
Provider Name (Legal Business Name): GRACE ANN RAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4778 OVERTON RD
BIRMINGHAM AL
35210-3803
US

IV. Provider business mailing address

1405 W SUNFLOWER RD
CLEVELAND MS
38732-2404
US

V. Phone/Fax

Practice location:
  • Phone: 205-957-0294
  • Fax: 205-957-0298
Mailing address:
  • Phone: 662-545-1017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS-5228
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6025
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: