Provider Demographics
NPI:1912560368
Name:PERKINS, RACHEL KELLY (RBT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:KELLY
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:KELLY
Other - Last Name:MAGNESEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1443 W 800 N STE 103
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2878
Mailing Address - Country:US
Mailing Address - Phone:801-655-4950
Mailing Address - Fax:
Practice Address - Street 1:4855 S 250 W APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON TERRACE
Practice Address - State:UT
Practice Address - Zip Code:84405-6466
Practice Address - Country:US
Practice Address - Phone:435-632-6904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-20
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTRBT-19-84528106S00000X
2255A2300X
UT2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician