Provider Demographics
NPI:1285947390
Name:REHN, PHYLLIS A (LPC, CMHC)
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:A
Last Name:REHN
Suffix:
Gender:F
Credentials:LPC, CMHC
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:A
Other - Last Name:REHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, RN
Mailing Address - Street 1:12351 ROSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KAMAS
Mailing Address - State:UT
Mailing Address - Zip Code:84036-9316
Mailing Address - Country:US
Mailing Address - Phone:435-659-8324
Mailing Address - Fax:
Practice Address - Street 1:12351 ROSS CREEK DR
Practice Address - Street 2:
Practice Address - City:KAMAS
Practice Address - State:UT
Practice Address - Zip Code:84036-9316
Practice Address - Country:US
Practice Address - Phone:435-659-8324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7527305-6004101YP2500X
UT7527305-3102281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional