| Doctor Name: | MISS TRACI ANN RAY |
| NPI Number: | 1104045871 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS RD |
| License Number: | 864188 |
| Business Practice Address: | 2200 N Section St Sullivan, IN - 478827523 |
| Business Phone Number: | 8122684311 |
| Business Fax Number: | 8122682648 |
| Mailing Address: | 11388 Lake Rd, TERRE HAUTE |
| State: | IN |
| Postal Code: | 478028437 |
| Phone Number: | 8128942205 |
| Fax Number: | 8128942205 |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 864188 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |