Provider Demographics
NPI:1366827321
Name:BOND, KAYZANDRA LEIGH EXUM (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAYZANDRA
Middle Name:LEIGH EXUM
Last Name:BOND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAYZANDRA
Other - Middle Name:LEIGH
Other - Last Name:EXUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2307 NORWOOD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1601
Mailing Address - Country:US
Mailing Address - Phone:252-493-6525
Mailing Address - Fax:
Practice Address - Street 1:2307 NORWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1601
Practice Address - Country:US
Practice Address - Phone:252-493-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4812101YM0800X
NC5453103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health