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Individual
JUANITA M KISSELL
Active
Individual
JUANITA M KISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC, CCMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC2686
TN
101YP2500X
Professional Counselor
LPC00545
MN
101YP2500X
Professional Counselor
LPCC1290
KY
Other
Enumeration date
09/30/2010
Last updated
11/18/2015
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