Provider Demographics
NPI:1427780758
Name:RAY OF SUNSHINE THERAPEUTIC SOLUTIONS, PLLC
Entity type:Organization
Organization Name:RAY OF SUNSHINE THERAPEUTIC SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:804-874-0227
Mailing Address - Street 1:1524 CREEK KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834-6820
Mailing Address - Country:US
Mailing Address - Phone:804-874-0227
Mailing Address - Fax:
Practice Address - Street 1:1524 CREEK KNOLL CT
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23834-6820
Practice Address - Country:US
Practice Address - Phone:804-874-0227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-52785OtherBACB