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General NPI Number Information
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NPI Number | 1427091370
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Entity Type | Individual
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Provider Name | MICHELLE G RAY MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 505 W VANDAMENT AVE
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City | YUKON
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State | OK
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Zip | 73099-4663
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Country | US
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Telephone | 405-517-3467
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Fax |
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Provider Business Mailing Address
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Address Line | 904 WALSH LN
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City | YUKON
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State | OK
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Zip | 73099-4230
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Country | US
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Telephone | 405-354-5595
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Fax | 405-354-5595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1671
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License Number State | OK
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