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Individual
KIMBERLY M PERSAUD
Active
Individual
KIMBERLY M PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBA,MS
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NY
103TB0200X
Cognitive & Behavioral Psychologist
—
NY
103TC1900X
Counseling Psychologist
—
NY
103TC2200X
Clinical Child & Adolescent Psychologist
—
NY
103TF0000X
Family Psychologist
—
NY
103TP2701X
Group Psychotherapy Psychologist
—
NY
251B00000X
Case Management Agency
—
NULL
251B00000X
Case Management Agency
—
NY
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
11/21/2021
Last updated
08/15/2023
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