Provider Demographics
NPI:1487442679
Name:SANDS, KIANA
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIANA
Other - Middle Name:
Other - Last Name:SMALLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:57 PARK AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7459
Mailing Address - Country:US
Mailing Address - Phone:631-482-0688
Mailing Address - Fax:
Practice Address - Street 1:57 PARK AVE APT 303
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7459
Practice Address - Country:US
Practice Address - Phone:631-482-0688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health