Healthcare Provider Details

I. General information

NPI: 1952988453
Provider Name (Legal Business Name): ALEXIA MARY WRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CARLY LANE
BIGFORK MT
59911
US

IV. Provider business mailing address

439 GRAND DR # 218
BIGFORK MT
59911-3614
US

V. Phone/Fax

Practice location:
  • Phone: 541-610-3231
  • Fax:
Mailing address:
  • Phone: 541-610-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: