Provider Demographics
NPI:1447901061
Name:MURRAY, RITA (RBT)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-8939
Mailing Address - Country:US
Mailing Address - Phone:435-790-5868
Mailing Address - Fax:
Practice Address - Street 1:1360 W HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-4203
Practice Address - Country:US
Practice Address - Phone:435-789-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTRBT-22-199822106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician