Provider Demographics
NPI:1477753648
Name:RAYNOR, VANESSA (SLPD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:RAYNOR
Suffix:
Gender:F
Credentials:SLPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 COURTNEY CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1510
Mailing Address - Country:US
Mailing Address - Phone:919-475-7343
Mailing Address - Fax:919-767-5513
Practice Address - Street 1:3007 COURTNEY CREEK BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1510
Practice Address - Country:US
Practice Address - Phone:919-475-7343
Practice Address - Fax:919-767-5513
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist