Healthcare Provider Details

I. General information

NPI: 1609700509
Provider Name (Legal Business Name): RITUAL SKIN & HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 S 1100 E STE B
SALT LAKE CITY UT
84105-2478
US

IV. Provider business mailing address

1549 S 1100 E STE B
SALT LAKE CITY UT
84105-2478
US

V. Phone/Fax

Practice location:
  • Phone: 801-448-3365
  • Fax: 801-457-5022
Mailing address:
  • Phone: 801-448-3365
  • Fax: 801-457-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TINA CHANTE
Title or Position: OWNER/ MEDICAL DIRECTOR
Credential: APRN/FNP-C
Phone: 801-448-3365