Provider Demographics
NPI:1437626553
Name:RAWLINS, PENNY
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PENNY
Other - Middle Name:
Other - Last Name:RAWLINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACMHC
Mailing Address - Street 1:9263 S REDWOOD RD BLDG 8
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-6571
Mailing Address - Country:US
Mailing Address - Phone:801-566-0749
Mailing Address - Fax:801-566-7108
Practice Address - Street 1:9263 S REDWOOD RD BLDG 8
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-6571
Practice Address - Country:US
Practice Address - Phone:801-566-0749
Practice Address - Fax:801-566-7108
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10148069-6009101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor