Provider Demographics
NPI:1871268375
Name:RAAYMAKERS, AIDYN LAINE
Entity Type:Individual
Prefix:
First Name:AIDYN
Middle Name:LAINE
Last Name:RAAYMAKERS
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 1:901 GRAND RAPIDS ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-9498
Mailing Address - Country:US
Mailing Address - Phone:269-320-3562
Mailing Address - Fax:
Practice Address - Street 1:3809 LAKE EASTBROOK BLVD SE STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5931
Practice Address - Country:US
Practice Address - Phone:616-604-8492
Practice Address - Fax:616-604-8493
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician