Healthcare Provider Details

I. General information

NPI: 1508530650
Provider Name (Legal Business Name): RACHEL LEIGH YOUNGER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S 400 E
SALT LAKE CITY UT
84111-2905
US

IV. Provider business mailing address

350 S 400 E
SALT LAKE CITY UT
84111-2905
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-5534
  • Fax:
Mailing address:
  • Phone: 801-582-5534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: