Provider Demographics
NPI:1316553704
Name:HAY, RAYNELL ELIZABETH (LMT)
Entity Type:Individual
Prefix:
First Name:RAYNELL
Middle Name:ELIZABETH
Last Name:HAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3031
Mailing Address - Country:US
Mailing Address - Phone:240-426-2444
Mailing Address - Fax:
Practice Address - Street 1:5240 PRIMROSE CT APT 104
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2996
Practice Address - Country:US
Practice Address - Phone:240-426-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM06090225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist