Green, Rachal
Green, Rachal is an sole proprietor health care provider with primary practice located at 6013 S Redwood Rd , Salt Lake City UT 84123-5220. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Green, Rachal can be contacted via phone (801) 255-5131.Contact Information
Primary practice address
6013 S Redwood Rd
Salt Lake City UT 84123-5220
Phone: (801) 255-5131
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 8368793-2506 | Utah |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 8368793-3502 | Utah |
Profile Details
| NPI number | 1275812166 |
|---|---|
| LBN Legal business name | Green, Rachal |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2011 |
| Last updated | Jan 17th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275812166 | NPPES |
| Utah | Other | 260022408 | RAILROAD MEDICARE |
| Utah | MEDICAID | 876000308007 | RAILROAD MEDICARE |
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