Provider Demographics
NPI:1033998927
Name:SANTO, RAYNA
Entity type:Individual
Prefix:
First Name:RAYNA
Middle Name:
Last Name:SANTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 955
Mailing Address - Street 2:
Mailing Address - City:THAYNE
Mailing Address - State:WY
Mailing Address - Zip Code:83127-0955
Mailing Address - Country:US
Mailing Address - Phone:719-289-8156
Mailing Address - Fax:
Practice Address - Street 1:1341STRAWBERRY CREEK PRIVATE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:WY
Practice Address - Zip Code:83112-8311
Practice Address - Country:US
Practice Address - Phone:719-289-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities