| Doctor Name: | BRENDA MARIE RAY |
| NPI Number: | 1164620381 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MRC, LPC |
| License Number: | P0107025 |
| Business Practice Address: | 106 East Third St Imboden, AR - 72434 |
| Business Phone Number: | 8708691500 |
| Business Fax Number: | 8708691500 |
| Mailing Address: | 1205 Charles St, IMBODEN |
| State: | AR |
| Postal Code: | 724349004 |
| Phone Number: | 8708691500 |
| Fax Number: | 8708691500 |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | P0107025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |