Provider Demographics
NPI:1467074179
Name:KAY, DANIEL BRICE (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRICE
Last Name:KAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:BRICE
Other - Last Name:HANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3549 N UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4417
Mailing Address - Country:US
Mailing Address - Phone:385-201-4429
Mailing Address - Fax:
Practice Address - Street 1:3549 N UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4417
Practice Address - Country:US
Practice Address - Phone:385-201-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10085312-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical