Healthcare Provider Details

I. General information

NPI: 1346947355
Provider Name (Legal Business Name): KALANI WHITMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3098 W EXECUTIVE PKWY STE 280
LEHI UT
84048-4949
US

IV. Provider business mailing address

3098 W EXECUTIVE PKWY STE 280
LEHI UT
84048-4949
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-7569
  • Fax:
Mailing address:
  • Phone: 801-477-7569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14222083-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: