Provider Demographics
NPI:1154139624
Name:RAYFIELD, GEORGIA (BHT/RBT)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:
Last Name:RAYFIELD
Suffix:
Gender:F
Credentials:BHT/RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W BACON ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3915
Mailing Address - Country:US
Mailing Address - Phone:570-593-5484
Mailing Address - Fax:
Practice Address - Street 1:150 CHAMBERLAINE AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8648
Practice Address - Country:US
Practice Address - Phone:570-593-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician