Provider Demographics
NPI:1588708804
Name:RATH, ANTJE A (CMHC)
Entity type:Individual
Prefix:MS
First Name:ANTJE
Middle Name:A
Last Name:RATH
Suffix:
Gender:
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 WILLIAMS WAY STE B
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2065
Mailing Address - Country:US
Mailing Address - Phone:435-719-5550
Mailing Address - Fax:435-719-5551
Practice Address - Street 1:476 WILLIAMS WAY STE B
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2065
Practice Address - Country:US
Practice Address - Phone:435-719-5550
Practice Address - Fax:435-719-5551
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6358921-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health