Provider Demographics
NPI:1205017324
Name:RAYFIELD, GINA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:E
Last Name:RAYFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2622
Mailing Address - Country:US
Mailing Address - Phone:973-927-1818
Mailing Address - Fax:973-927-1679
Practice Address - Street 1:24 E LOGAN RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2622
Practice Address - Country:US
Practice Address - Phone:973-927-1818
Practice Address - Fax:973-927-1679
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00229300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist