Individual
KAISHA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 S OREM BLVD, OREM, UT 84058-5011
(801) 960-9622
(801) 373-0639
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13432043-3502
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/10/2021
Last updated
04/18/2024
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