Healthcare Provider Details

I. General information

NPI: 1699652479
Provider Name (Legal Business Name): KIONA EDWARDS MA, LCAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N CENTRE AVE STE 310
ROCKVILLE CENTRE NY
11570-3923
US

IV. Provider business mailing address

304 IRON RIDGE LOOP APT 1
ASHEVILLE NC
28806-0350
US

V. Phone/Fax

Practice location:
  • Phone: 516-740-1950
  • Fax:
Mailing address:
  • Phone: 850-226-2779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberP120722
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: