Provider Demographics
NPI:1871213652
Name:DAVIES, KAILON
Entity type:Individual
Prefix:
First Name:KAILON
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAILON
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TRS, CTRS
Mailing Address - Street 1:120 N 200 W
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84150-9001
Mailing Address - Country:US
Mailing Address - Phone:855-537-1000
Mailing Address - Fax:
Practice Address - Street 1:104 W MEDICAL DR STE 1
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-3191
Practice Address - Country:US
Practice Address - Phone:801-955-3600
Practice Address - Fax:801-955-3600
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical