Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicholas Eric Ray, MAT

Individual provider Developmental Disabilities Clinic/Center · NPI 1104415801

Nicholas Eric Ray, MAT is a Developmental Disabilities Clinic/Center in Germantown, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2021
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Practice location Address checks out

1507 Poplar Estates Pkwy
Germantown, TN 38138-1840
Phone: (901) 828-1146
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Specialties & licences

Developmental Disabilities Clinic/Center (primary) Taxonomy 261QD1600X · Licence 200004323 (TN)

Record details

NPI number1104415801
Entity typeIndividual (Type 1)
GenderMale
Credentials MAT
Sole proprietorYes
NPI enumeratedJanuary 16, 2021
Last updated in NPPESJanuary 16, 2021
Certification dateJanuary 16, 2021
Mailing address1507 Poplar Estates Pkwy, Germantown, TN 38138-1840