Provider Demographics
NPI:1386233112
Name:DIOUF, KAY CEE
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:CEE
Last Name:DIOUF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 BURRELL AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-5849
Mailing Address - Country:US
Mailing Address - Phone:208-340-1812
Mailing Address - Fax:
Practice Address - Street 1:1408 BURRELL AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-5849
Practice Address - Country:US
Practice Address - Phone:208-340-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician