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Individual
MR. STANLEY CHESTER KISIEL JR.
Active
Individual
MR. STANLEY CHESTER KISIEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001187
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004052015
—
CT
01
—
269952
MANAGED HEALTH NETWORK
CT
01
—
77ABH0021CT01
ANTHEM
CT
01
—
ANC1482
OXFORD HEALTH PLANS
CT
01
—
CTGA000438 B000602
SAGA GRP
CT
Enumeration date
10/06/2006
Last updated
04/04/2013
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