Provider Demographics
NPI:1407413842
Name:TOYE SHEPHERD, KIAMESHA
Entity Type:Individual
Prefix:
First Name:KIAMESHA
Middle Name:
Last Name:TOYE SHEPHERD
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 1:265 E BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-3712
Mailing Address - Country:US
Mailing Address - Phone:718-583-7589
Mailing Address - Fax:
Practice Address - Street 1:6210 CHERRY HILL DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1707
Practice Address - Country:US
Practice Address - Phone:845-546-6490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical