MEDICARE: RAELYNN SANCHEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	4151001122	MI

General Provider Information

NPI Number	:	1093570640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAELYNN SANCHEZ

Provider Business Mailing Address
First Line	:	20508 STARINA DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-7503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 E BIG BEAVER RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1418
Country	:	US
Telephone Number	:	248-677-1421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2024
Last Update Date	:	02/13/2024

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Directions to “ RAELYNN SANCHEZ ” Practice Location

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