Provider Demographics
NPI:1669358602
Name:ABRAHAM, LARAY (RDH, LE, IHC, LMT,CD)
Entity type:Individual
Prefix:MS
First Name:LARAY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:RDH, LE, IHC, LMT,CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 FOUNDRY STREET MAILBOX 2006
Mailing Address - Street 2:SUITE 043
Mailing Address - City:SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20763
Mailing Address - Country:US
Mailing Address - Phone:443-510-7055
Mailing Address - Fax:
Practice Address - Street 1:8600 FOUNDRY STREET MAILBOX 2006
Practice Address - Street 2:SUITE 043
Practice Address - City:SAVAGE
Practice Address - State:MD
Practice Address - Zip Code:20763
Practice Address - Country:US
Practice Address - Phone:443-510-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5944124Q00000X
MD171400000X, 174H00000X, 374J00000X
MDM06893225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No124Q00000XDental ProvidersDental Hygienist
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist