Provider Demographics
NPI:1093295669
Name:RAYHER, CODY (MA, CAS)
Entity Type:Individual
Prefix:MS
First Name:CODY
Middle Name:
Last Name:RAYHER
Suffix:
Gender:F
Credentials:MA, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6308
Mailing Address - Country:US
Mailing Address - Phone:203-809-4240
Mailing Address - Fax:
Practice Address - Street 1:285 SAVIN AVE APT A7
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-5832
Practice Address - Country:US
Practice Address - Phone:412-720-1629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC062018000293103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty