Individual
LARIE RAYBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 MAGAZINE ST, LOUISVILLE, KY 40203-2043
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
1113075
KY
Other
Enumeration date
09/30/2009
Last updated
05/29/2014
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