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1033152418
TARA FAWN RAY
SOUTH CHARLESTON, WV
NPI
1033152418
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Former Name
TARA FAWN ALFORD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WV 2117)
Enumeration Date
2006-06-14
Last Update Date
2012-05-17
Business Address
Dr. TARA FAWN RAY DO
400 DIVISION ST SUITE 3
SOUTH CHARLESTON, WV 25309-1459
Phone number: 304-767-7960
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Mailing Address
Dr. TARA FAWN RAY DO
PO BOX 9189
SOUTH CHARLESTON, WV 25309-0189
Phone number: 304-767-7960
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