Provider Demographics
NPI:1902561889
Name:KAUO DEISHER AND ASSOCIATES
Entity Type:Organization
Organization Name:KAUO DEISHER AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-885-2088
Mailing Address - Street 1:1330 E 900 S
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-6307
Mailing Address - Country:US
Mailing Address - Phone:801-885-2088
Mailing Address - Fax:
Practice Address - Street 1:1330 E 900 S
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-6307
Practice Address - Country:US
Practice Address - Phone:801-885-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty