Provider Demographics
NPI:1356075386
Name:RICHARDS, KAYANN MONIQUE (MS)
Entity Type:Individual
Prefix:
First Name:KAYANN
Middle Name:MONIQUE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8317 MEADOW SWEET LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-5039
Mailing Address - Country:US
Mailing Address - Phone:862-684-0971
Mailing Address - Fax:
Practice Address - Street 1:8317 MEADOW SWEET LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-5039
Practice Address - Country:US
Practice Address - Phone:862-684-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist