MEDICARE: DR. BRETT SCOTT RAYFORD PSY.D.

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	103TC0700X	Clinical Psychologist	001715	CT

General Provider Information

NPI Number	:	1922738392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT SCOTT RAYFORD PSY.D.

Provider Business Mailing Address
First Line	:	1824 RICHTREE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1651
Country	:	US
Telephone Number	:	203-645-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	5965 E BROAD ST STE 350
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1533
Country	:	US
Telephone Number	:	203-645-3156
Fax Number	:

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

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/16/2022

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