Provider Demographics
NPI:1861723454
Name:RAYNOR, CATHERINE SMITH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:SMITH
Last Name:RAYNOR
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 OLD BRAMBLE LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-6994
Mailing Address - Country:US
Mailing Address - Phone:919-434-8780
Mailing Address - Fax:
Practice Address - Street 1:1101 OLD BRAMBLE LN
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-6994
Practice Address - Country:US
Practice Address - Phone:919-434-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist