Healthcare Provider Details

I. General information

NPI: 1225196355
Provider Name (Legal Business Name): JAMES HUNTER RAIFORD MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S 4TH AVE
STURGIS MI
49091
US

IV. Provider business mailing address

103 S 4TH AVE
STURGIS MI
49091
US

V. Phone/Fax

Practice location:
  • Phone: 269-651-3902
  • Fax: 269-659-4874
Mailing address:
  • Phone: 269-651-3902
  • Fax: 269-659-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401006552
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: