Provider Demographics
NPI:1447529565
Name:ARIAS, KYLAH BERNARDO (PSYD)
Entity type:Individual
Prefix:DR
First Name:KYLAH
Middle Name:BERNARDO
Last Name:ARIAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KYLAH
Other - Middle Name:ANN
Other - Last Name:BERNARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5503 31ST AVE
Mailing Address - Street 2:APT. 3P
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-1646
Mailing Address - Country:US
Mailing Address - Phone:203-464-1070
Mailing Address - Fax:
Practice Address - Street 1:85 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-1803
Practice Address - Country:US
Practice Address - Phone:860-224-3642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019369103TC0700X
CT4210103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical