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Individual

RAPHAEL CORLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
172 E 14075 S STE 110, DRAPER, UT 84020-5725
(801) 899-0732
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(801) 273-6345

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1811472962
UT
1041C0700X
Clinical Social Worker
Primary
10853087-3501
UT
1041C0700X
Clinical Social Worker
1041S0200X
School Social Worker
Primary
X-10610
NM

Other

Enumeration date
09/25/2018
Last updated
04/02/2026
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