Individual
RAELYNN MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5770 S 1500 W, TAYLORSVILLE, UT 84123-5216
(801) 265-3109
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 265-3109
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
194391-4405
UT
Other
Enumeration date
01/17/2007
Last updated
10/16/2007
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