Provider Demographics
NPI:1487864831
Name:RAAYMAKERS, CONNY M (LLP, BCBA)
Entity Type:Individual
Prefix:
First Name:CONNY
Middle Name:M
Last Name:RAAYMAKERS
Suffix:
Gender:F
Credentials:LLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1428 44TH ST SW
Mailing Address - Street 2:SUITE E
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-7202
Mailing Address - Country:US
Mailing Address - Phone:616-299-2493
Mailing Address - Fax:616-242-0099
Practice Address - Street 1:1428 44TH ST SW
Practice Address - Street 2:SUITE E
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-7202
Practice Address - Country:US
Practice Address - Phone:616-299-2493
Practice Address - Fax:616-242-0099
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103K00000X
MI6301014313103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist