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General NPI Number Information
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NPI Number | 1871043596
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Entity Type | Individual
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Provider Name | KENYA MAKHIAWALA PHD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 2213 FRANKLIN AVE
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City | TOLEDO
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State | OH
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Zip | 43620-1402
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Country | US
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Telephone | 419-251-2415
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Fax | 419-251-2415
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Provider Business Mailing Address
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Address Line | 2222 CHERRY ST STE 1900
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City | TOLEDO
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State | OH
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Zip | 43608-2673
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Country | US
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Telephone | 419-251-3878
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY 60603757
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | P.08747
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License Number State | OH
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