Ray, Kelly Paulk

Ray, Kelly Paulk is an individual health care provider with primary practice located at 7913 Wrenwood Blvd Ste A , Baton Rouge LA 70809. She recently has only one registered license in Behavioral Health & Social Service Providers / Prescribing (Medical), which is considered as her primary health care specialty. Ray, Kelly Paulk can be contacted via phone (225) 763-6300.

Contact Information

Primary practice address
7913 Wrenwood Blvd Ste A Baton Rouge LA 70809
Phone: (225) 763-6300
Fax: (225) 763-9358
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Prescribing (Medical) 103TP0016X MP.0862 Louisiana

Profile Details

NPI number 1437159639
LBN Legal business name Ray, Kelly Paulk
Credentials PHD, MP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Feb 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437159639 NPPES
Louisiana MEDICAID 1474657

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