Provider Demographics
NPI:1902205859
Name:RAY-EL, RAHIMAH BEN-ASAD
Entity Type:Individual
Prefix:
First Name:RAHIMAH
Middle Name:BEN-ASAD
Last Name:RAY-EL
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 1:20905 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5360
Mailing Address - Country:US
Mailing Address - Phone:248-809-3119
Mailing Address - Fax:248-996-8273
Practice Address - Street 1:20905 GREENFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5346
Practice Address - Country:US
Practice Address - Phone:248-809-3119
Practice Address - Fax:248-996-8273
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-16
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN359524201403123747P1801X
MI802619511261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant