Provider Demographics
NPI:1245011519
Name:RAYA, DAISY (LPA)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:RAYA
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W BELLA VISTA LN
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-7160
Mailing Address - Country:US
Mailing Address - Phone:956-372-0706
Mailing Address - Fax:
Practice Address - Street 1:423 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2915
Practice Address - Country:US
Practice Address - Phone:956-600-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39940103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist