| Raven, Lotus & Grey, Pllc | |
|
201 E South Temple Apt 133 Salt Lake City UT 84111-1294 | |
| (630) 338-5893 | |
| Not Available |
| Full Name | Raven, Lotus & Grey, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 201 E South Temple Apt 133, Salt Lake City, Utah |
| Authorized Official Name and Position | Amy Perry (OWNER/THERAPIST) |
| Authorized Official Contact | 6303385893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raven, Lotus & Grey, Pllc 201 E South Temple Apt 133 Salt Lake City UT 84111-1294 Ph: () - | Raven, Lotus & Grey, Pllc 201 E South Temple Apt 133 Salt Lake City UT 84111-1294 Ph: (630) 338-5893 |
| NPI Number | 1770299968 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770299968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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