Healthcare Provider Details

I. General information

NPI: 1578419750
Provider Name (Legal Business Name): AILEEN RANDS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 N 1300 W
SALT LAKE CITY UT
84116-3873
US

IV. Provider business mailing address

666 N 1300 W
SALT LAKE CITY UT
84116-3873
US

V. Phone/Fax

Practice location:
  • Phone: 915-497-7001
  • Fax:
Mailing address:
  • Phone: 915-497-7001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number14242824-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: