Provider Demographics
NPI:1881210235
Name:PERSAUD, KEISHA ASHLEY (SLP-CF)
Entity Type:Individual
Prefix:MISS
First Name:KEISHA
Middle Name:ASHLEY
Last Name:PERSAUD
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8791 LEFFERTS BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2514
Mailing Address - Country:US
Mailing Address - Phone:718-637-0424
Mailing Address - Fax:
Practice Address - Street 1:8791 LEFFERTS BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2514
Practice Address - Country:US
Practice Address - Phone:718-637-0424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist