Provider Demographics
NPI:1487331674
Name:DAMAS, KYONNA MICHELLA
Entity type:Individual
Prefix:
First Name:KYONNA
Middle Name:MICHELLA
Last Name:DAMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KYONNA
Other - Middle Name:MICHELLA
Other - Last Name:BROWN MCFARLANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 PUTNAM PIKE APT 6
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-2054
Mailing Address - Country:US
Mailing Address - Phone:857-300-0967
Mailing Address - Fax:
Practice Address - Street 1:1020 PARK AVE STE 211
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-3227
Practice Address - Country:US
Practice Address - Phone:401-318-2518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No171400000XOther Service ProvidersHealth & Wellness Coach
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist