Provider Demographics
NPI:1679469274
Name:JOSEPH, KYANNA
Entity type:Individual
Prefix:MISS
First Name:KYANNA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KYANNA
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:32 BRIAR BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HALL
Mailing Address - State:NY
Mailing Address - Zip Code:10916-3502
Mailing Address - Country:US
Mailing Address - Phone:845-271-8872
Mailing Address - Fax:
Practice Address - Street 1:815 BLOOMING GROVE TPKE STE 601
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8138
Practice Address - Country:US
Practice Address - Phone:845-527-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist