Individual
MRS. RAE LOUISE LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
4249 E BUCKTOOTH RUN RD, LITTLE VALLEY, NY 14755-9753
(716) 945-3981
Mailing address
4249 E BUCKTOOTH RUN RD, SUITE 4010, LITTLE VALLEY, NY 14755-9753
(716) 945-3981
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/21/2012
Last updated
06/25/2013
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