Healthcare Provider Details

I. General information

NPI: 1669388138
Provider Name (Legal Business Name): KD EMPOWERMENT & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 VALLEY ST BLDG 6M
PROVIDENCE RI
02909-2400
US

IV. Provider business mailing address

166 VALLEY ST BLDG 6M
PROVIDENCE RI
02909-2400
US

V. Phone/Fax

Practice location:
  • Phone: 401-470-5494
  • Fax:
Mailing address:
  • Phone: 401-470-5494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: KASANDRA DOZIER
Title or Position: COMMUNITY HEALTH WORKER
Credential:
Phone: 401-470-5494