Provider Demographics
NPI:1013456250
Name:REYES-GIORDANO, KIMBERLY (PHD, BCBA-D, LBA)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:REYES-GIORDANO
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 15TH ST
Mailing Address - Street 2:APT A1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4865
Mailing Address - Country:US
Mailing Address - Phone:917-843-3619
Mailing Address - Fax:
Practice Address - Street 1:205 15TH ST
Practice Address - Street 2:APT A1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4865
Practice Address - Country:US
Practice Address - Phone:917-843-3619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000604-1103K00000X
NY024395103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst