Individual
KENNETH LEE DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
202 RIVERSIDE DR APT 9F, NEW YORK, NY 10025-7280
(212) 472-3137
Mailing address
202 RIVERSIDE DR APT 9F, NEW YORK, NY 10025-7280
(212) 472-3137
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8158
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021395
GHI
—
05
—
01674693
—
NY
Enumeration date
07/12/2006
Last updated
12/30/2020
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