Provider Demographics
NPI:1972390573
Name:KE THERAPY PLLC
Entity type:Organization
Organization Name:KE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:TAHIRA
Authorized Official - Last Name:EWALT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:435-572-0340
Mailing Address - Street 1:168 E COLLEGE AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3369
Mailing Address - Country:US
Mailing Address - Phone:435-572-0340
Mailing Address - Fax:
Practice Address - Street 1:168 E COLLEGE AVE UNIT C
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3369
Practice Address - Country:US
Practice Address - Phone:435-572-0340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty