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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICHOLAS ERIC RAY, MAT

Active Sole Proprietor

NICHOLAS ERIC RAY, MAT is a Developmental Disabilities Clinic healthcare provider located in GERMANTOWN, Tennessee. NPI 1104415801 is currently active in the NPPES registry. Verify at CMS.

Developmental Disabilities Clinic · GERMANTOWN, TN

Registration Details

NPI Number
1104415801
Provider Type
Individual
Gender
Male
NPI Issued
Jan 16, 2021 (5.585996235356 yrs)
Last Updated
Jan 16, 2021
License
200004323 (TN)
Sole Proprietor
Yes

Practice Information

Address
1507 POPLAR ESTATES PKWY
GERMANTOWN, TN, 381381840
Browse TN providers · Browse ZIP 38138
Phone
9018281146
Primary Specialty
Developmental Disabilities Clinic
261QD1600X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.