Provider Demographics
NPI:1710040548
Name:LYGHT, RAINA (PT)
Entity Type:Individual
Prefix:
First Name:RAINA
Middle Name:
Last Name:LYGHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RAINA
Other - Middle Name:
Other - Last Name:DOMNEYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2000 MEDICAL PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3742
Mailing Address - Country:US
Mailing Address - Phone:410-268-8862
Mailing Address - Fax:410-280-4701
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:410-268-8862
Practice Address - Fax:410-280-4701
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist