Healthcare Provider Details

I. General information

NPI: 1326995564
Provider Name (Legal Business Name): RACHEL ALLISON JOHNSON TRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 E 5350 S
WASHINGTON TERRACE UT
84405-6934
US

IV. Provider business mailing address

231 N 800 E
BOUNTIFUL UT
84010-3640
US

V. Phone/Fax

Practice location:
  • Phone: 801-479-6700
  • Fax:
Mailing address:
  • Phone: 602-625-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number14276680-4003
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: