# RANDY RAY ENTERPRISES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Intentional Family Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912234865
- **Authorized official:** MS. SUSAN L. JOHNSON LMFT (PARTNER/PROGRAM DIRECTOR)
- **Authorized official phone:** (801) 738-4369

## Contact information

- **Practice address:** 3900 SOUTH AVENUE, 220 EAST AVENUE, SUITE 7, SALT LAKE CITY, UT 84107
- **Practice address phone:** (801) 738-4369
- **Mailing address:** 2936 LAKE MARY DR, SALT LAKE CITY, UT 84121-5331
- **Mailing address phone:** (801) 860-9627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 59432763902 | UT | Yes |

## Other

- **Enumeration date:** 11/13/2009
- **Last updated:** 11/13/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11798095 | CAQH | UT |