Provider Demographics
NPI:1255126116
Name:KEENEY, RAYELLE (LMT)
Entity type:Individual
Prefix:
First Name:RAYELLE
Middle Name:
Last Name:KEENEY
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4890 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9754
Mailing Address - Country:US
Mailing Address - Phone:330-282-2557
Mailing Address - Fax:330-652-0574
Practice Address - Street 1:1160 NILES CORTLAND RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-3596
Practice Address - Country:US
Practice Address - Phone:330-652-4222
Practice Address - Fax:330-652-0574
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.026641225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist