Provider Demographics
NPI:1699811760
Name:RAYMOND, MARY ANN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 STONY LN
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-2703
Mailing Address - Country:US
Mailing Address - Phone:401-295-2940
Mailing Address - Fax:401-295-8694
Practice Address - Street 1:125 STONY LN
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:RI
Practice Address - Zip Code:02822-2703
Practice Address - Country:US
Practice Address - Phone:401-295-2940
Practice Address - Fax:401-295-8694
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT43106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist