Provider Demographics
NPI:1235298316
Name:DELCAMBRE, KYRA DAWN (MCMHC, LPC)
Entity Type:Individual
Prefix:MISS
First Name:KYRA
Middle Name:DAWN
Last Name:DELCAMBRE
Suffix:
Gender:F
Credentials:MCMHC, LPC
Other - Prefix:MISS
Other - First Name:KYRA
Other - Middle Name:DAWN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCMHC, LPC
Mailing Address - Street 1:2740 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3320
Mailing Address - Country:US
Mailing Address - Phone:801-392-5971
Mailing Address - Fax:801-393-5953
Practice Address - Street 1:2740 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3320
Practice Address - Country:US
Practice Address - Phone:801-392-5971
Practice Address - Fax:801-393-5953
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3728101YP2500X
UT6071470-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional