Provider Demographics
NPI:1952170490
Name:FEATHERLY-GRAUL, CARRI MICHELLE
Entity Type:Individual
Prefix:
First Name:CARRI
Middle Name:MICHELLE
Last Name:FEATHERLY-GRAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARRI
Other - Middle Name:MICHELLE
Other - Last Name:BLASER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:754 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-1612
Mailing Address - Country:US
Mailing Address - Phone:435-228-6523
Mailing Address - Fax:
Practice Address - Street 1:754 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-1612
Practice Address - Country:US
Practice Address - Phone:435-228-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty