Provider Demographics
NPI:1033870340
Name:HALL-TONEY, KYANA TAJE
Entity Type:Individual
Prefix:
First Name:KYANA
Middle Name:TAJE
Last Name:HALL-TONEY
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 1:1051 S PARK RD APT 304
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8791
Mailing Address - Country:US
Mailing Address - Phone:631-455-7812
Mailing Address - Fax:
Practice Address - Street 1:1051 S PARK RD APT 304
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8791
Practice Address - Country:US
Practice Address - Phone:631-455-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist