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General NPI Number Information
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NPI Number | 1144814716
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Entity Type | Individual
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Provider Name | KYAH GORIN PAIVA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 85 E NEWTON ST
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City | BOSTON
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State | MA
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Zip | 02118-3553
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Country | US
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Telephone | 617-305-9916
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Fax |
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Provider Business Mailing Address
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Address Line | 792 WEST ST APT F108
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City | MANSFIELD
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State | MA
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Zip | 02048-4105
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Country | US
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Telephone | 860-334-9934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 11450
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License Number State | MA
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