Healthcare Provider Details

I. General information

NPI: 1760167035
Provider Name (Legal Business Name): TARIRO RACHEL REEVES MFT-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E 5600 S STE 200
MURRAY UT
84107-8150
US

IV. Provider business mailing address

4721 W MIDDLEBORO RD
HERRIMAN UT
84096-7473
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-5418
  • Fax:
Mailing address:
  • Phone: 385-216-5335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: