Provider Demographics
NPI:1386221760
Name:KANE, DAVIS KEALANOHEA (PHD)
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:KEALANOHEA
Last Name:KANE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 N UNIVERSITY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-7412
Mailing Address - Country:US
Mailing Address - Phone:801-609-8847
Mailing Address - Fax:
Practice Address - Street 1:3325 N UNIVERSITY AVE STE 300
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-7412
Practice Address - Country:US
Practice Address - Phone:801-609-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling