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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275812166 NPPES
Utah Other 260022408 RAILROAD MEDICARE
Utah MEDICAID 876000308007 RAILROAD MEDICARE

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