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Organization
RANDY RAY ENTERPRISES LLC
Active
Organization
RANDY RAY ENTERPRISES LLC
Active
Other names
Intentional Family Institute
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN L. JOHNSON LMFT (PARTNER/PROGRAM DIRECTOR)
(801) 738-4369
Entity
Organization
Contact information
Practice address
3900 SOUTH AVENUE, 220 EAST AVENUE, SUITE 7, SALT LAKE CITY, UT 84107
(801) 738-4369
Mailing address
2936 LAKE MARY DR, SALT LAKE CITY, UT 84121-5331
(801) 860-9627
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
59432763902
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11798095
CAQH
UT
Enumeration date
11/13/2009
Last updated
11/13/2009
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