Provider Demographics
NPI:1437313699
Name:RAYMER, ANNE MARIE B
Entity Type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:B
Last Name:RAYMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3455
Mailing Address - Country:US
Mailing Address - Phone:330-726-8855
Mailing Address - Fax:330-726-9182
Practice Address - Street 1:6614 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-3455
Practice Address - Country:US
Practice Address - Phone:330-726-8855
Practice Address - Fax:330-726-9182
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP6157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11738248OtherCAQH
OH000000175061OtherUNISON
OH000000175061OtherUNISON