Individual provider Active NPI

Denise M Wray, PH.D.

  • Speech-Language Pathologist
  • Tallmadge, OH
National Provider Identifier
1538398235
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1672 Issued in OH
Practice address
412 Victoria Park Dr
Tallmadge, OH 44278-1574
Phone
(330) 972-8188
Fax
(330) 972-7884
NPI assigned
Jul 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1672 OH Primary

Addresses

Primary practice location

412 Victoria Park Dr
Tallmadge, OH 44278-1574

Mailing address

412 Victoria Park Dr
Tallmadge, OH 44278-1574
Phone (330) 972-8188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1672OHMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1538398235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 VICTORIA PARK DR",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781574",
            "telephone_number": "330-972-8188",
            "fax_number": "330-972-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 VICTORIA PARK DR",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781574",
            "telephone_number": "330-972-8188",
            "fax_number": "330-972-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "DENISE",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "1672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallmadge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.