Healthcare Provider Details

I. General information

NPI: 1508960063
Provider Name (Legal Business Name): KATHLEEN KAIR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 S HIGHLAND DR STE 111
SANDY UT
84093-7403
US

IV. Provider business mailing address

8160 S HIGHLAND DR STE 111
SANDY UT
84093-7403
US

V. Phone/Fax

Practice location:
  • Phone: 801-792-4129
  • Fax:
Mailing address:
  • Phone: 801-792-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number134765-2501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number134765-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: