Provider Demographics
NPI:1700096633
Name:HALEY, RAYLON GARNELL (LCDC)
Entity Type:Individual
Prefix:MR
First Name:RAYLON
Middle Name:GARNELL
Last Name:HALEY
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 SKELTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3742
Mailing Address - Country:US
Mailing Address - Phone:281-999-9013
Mailing Address - Fax:
Practice Address - Street 1:1700 FM 1960 RD W STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3209
Practice Address - Country:US
Practice Address - Phone:281-866-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9474101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)