Provider Demographics
NPI:1396472809
Name:KALLI SAIBARA-COOK PHD, LLC
Entity type:Organization
Organization Name:KALLI SAIBARA-COOK PHD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIBARA-COOK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-556-2730
Mailing Address - Street 1:11075 S STATE STREET
Mailing Address - Street 2:#35
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-5187
Mailing Address - Country:US
Mailing Address - Phone:801-990-4310
Mailing Address - Fax:801-501-7317
Practice Address - Street 1:11075 S STATE STREET
Practice Address - Street 2:#35
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5187
Practice Address - Country:US
Practice Address - Phone:801-990-4310
Practice Address - Fax:801-501-7317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty