Healthcare Provider Details
I. General information
NPI: 1730092149
Provider Name (Legal Business Name): RAYE MASK
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29868 SENECA TRL
MARLINTON WV
24954-5553
US
IV. Provider business mailing address
501 WILSON LN
ELKINS WV
26241-5216
US
V. Phone/Fax
- Phone: 304-572-4692
- Fax:
- Phone: 304-572-4692
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: