Provider Demographics
NPI:1255581559
Name:RAINES, DANYLE G (COTA)
Entity type:Individual
Prefix:MRS
First Name:DANYLE
Middle Name:G
Last Name:RAINES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10832 EAST RD
Mailing Address - Street 2:
Mailing Address - City:PAVILION
Mailing Address - State:NY
Mailing Address - Zip Code:14525-9737
Mailing Address - Country:US
Mailing Address - Phone:585-344-2312
Mailing Address - Fax:
Practice Address - Street 1:10832 EAST RD
Practice Address - Street 2:
Practice Address - City:PAVILION
Practice Address - State:NY
Practice Address - Zip Code:14525-9737
Practice Address - Country:US
Practice Address - Phone:585-344-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005561-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant