Provider Demographics
NPI:1891675120
Name:GRAY, RAYNA IVORY
Entity type:Individual
Prefix:
First Name:RAYNA
Middle Name:IVORY
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 N SYDENHAM ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1615
Mailing Address - Country:US
Mailing Address - Phone:267-265-1278
Mailing Address - Fax:267-389-2785
Practice Address - Street 1:5125 N SYDENHAM ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1615
Practice Address - Country:US
Practice Address - Phone:267-265-1278
Practice Address - Fax:267-389-2785
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical