Provider Demographics
NPI:1346082526
Name:MCLEAN, RAYANNA (BS)
Entity type:Individual
Prefix:
First Name:RAYANNA
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 CALDWELL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-6403
Mailing Address - Country:US
Mailing Address - Phone:208-954-4066
Mailing Address - Fax:
Practice Address - Street 1:3307 CALDWELL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-6403
Practice Address - Country:US
Practice Address - Phone:208-465-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health