Individual
RAQUEL ELAN PEREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4460 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124-3550
(888) 949-4864
Mailing address
15 BUCKBOARD DR, SHERIDAN, MT 59749-9686
(504) 478-8868
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
08/02/2021
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