Provider Demographics
NPI:1285215822
Name:SAWYER, KYANNA DEMISHA
Entity Type:Individual
Prefix:
First Name:KYANNA
Middle Name:DEMISHA
Last Name:SAWYER
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 1:7 BIMINI XING APT D
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6108
Mailing Address - Country:US
Mailing Address - Phone:757-771-1020
Mailing Address - Fax:
Practice Address - Street 1:7 BIMINI XING APT D
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6108
Practice Address - Country:US
Practice Address - Phone:757-771-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health