Provider Demographics
NPI:1598477382
Name:WILLIAMS, RAINA
Entity Type:Individual
Prefix:
First Name:RAINA
Middle Name:
Last Name:WILLIAMS
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 1:22 W PENNSYLVANIA AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5009
Mailing Address - Country:US
Mailing Address - Phone:410-616-2940
Mailing Address - Fax:
Practice Address - Street 1:22 W PENNSYLVANIA AVE STE 304
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-5009
Practice Address - Country:US
Practice Address - Phone:410-616-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-23
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG09906104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker