Provider Demographics
NPI:1841907532
Name:RAYO, YANIZ A (MA)
Entity type:Individual
Prefix:
First Name:YANIZ
Middle Name:A
Last Name:RAYO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13305 S RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1808
Mailing Address - Country:US
Mailing Address - Phone:708-907-5149
Mailing Address - Fax:708-907-5294
Practice Address - Street 1:13305 S RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1808
Practice Address - Country:US
Practice Address - Phone:708-907-5149
Practice Address - Fax:708-907-5294
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1720573983OtherPRIVATE PRACTICE