| Doctor Name: | MR. KENNETH COREY RAWLINGS |
| NPI Number: | 1568712453 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 21360 N 1450 E Moroni, UT - 84646 |
| Business Phone Number: | 4354455200 |
| Business Fax Number: | |
| Mailing Address: | Po Box 461, 21360 N 1450 E MORONI |
| State: | UT |
| Postal Code: | 84646 |
| Phone Number: | 4354455200 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2012 |
| NPI Last Update Date: | 09/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |