Healthcare Provider Details

I. General information

NPI: 1003373929
Provider Name (Legal Business Name): RACHEL LEIGH HOPKINS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 S 900 E
SALT LAKE CITY UT
84102-4103
US

IV. Provider business mailing address

164 S 900 E
SALT LAKE CITY UT
84102-4103
US

V. Phone/Fax

Practice location:
  • Phone: 801-419-0139
  • Fax: 385-227-8099
Mailing address:
  • Phone: 801-419-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10941615-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: