Provider Demographics
NPI:1083948343
Name:PRICE, REBECCA ELLEN (LMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELLEN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 SAGEWOOD DR STE H
Mailing Address - Street 2:#301
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7502
Mailing Address - Country:US
Mailing Address - Phone:435-647-6880
Mailing Address - Fax:435-655-0981
Practice Address - Street 1:2760 RASMUSSEN RD
Practice Address - Street 2:200
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5684
Practice Address - Country:US
Practice Address - Phone:435-729-9089
Practice Address - Fax:435-655-0981
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6368023-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist