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Individual

KIMBERLY JOY BRAYTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., J.D.

Contact information

Practice address
92 BAY ST, GLENS FALLS, NY 12801-3031
(518) 480-3188
(518) 480-3189
Mailing address
92 BAY ST, GLENS FALLS, NY 12801-3031
(518) 792-9100
(518) 480-3189

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
016568
NY
103TC0700X
Clinical Psychologist
Primary
016568
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02694246
NY
Enumeration date
10/25/2005
Last updated
11/03/2023
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