Healthcare Provider Details

I. General information

NPI: 1790621274
Provider Name (Legal Business Name): HEATHER SUZANNE COLLINS RATCHFORD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 E 600 N
LOGAN UT
84321-3310
US

IV. Provider business mailing address

116 E 600 N
LOGAN UT
84321-3310
US

V. Phone/Fax

Practice location:
  • Phone: 436-881-1831
  • Fax:
Mailing address:
  • Phone: 436-881-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number14020716-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: