Provider Demographics
NPI:1780440990
Name:RAY, RACHEL M (LMT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHARPE
Mailing Address - Street 1:4902 BRIAR OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-1706
Mailing Address - Country:US
Mailing Address - Phone:407-807-8346
Mailing Address - Fax:
Practice Address - Street 1:4902 BRIAR OAKS CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-1706
Practice Address - Country:US
Practice Address - Phone:407-807-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9421225700000X
VA0019017466225700000X
FLMA96451225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist