Provider Demographics
NPI:1568267243
Name:MURRAY, REANNA SARAH
Entity type:Individual
Prefix:
First Name:REANNA
Middle Name:SARAH
Last Name:MURRAY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 OLD COURT RD STE 21A
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3901
Mailing Address - Country:US
Mailing Address - Phone:443-219-9236
Mailing Address - Fax:
Practice Address - Street 1:3701 OLD COURT RD STE 21A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3901
Practice Address - Country:US
Practice Address - Phone:443-219-9236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32781104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty