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Individual
RONALD L. KISSICK
Active
Individual
RONALD L. KISSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PRO154731-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1237792
AETNA
NY
01
—
G0184797040
EXCELLUS ROCHESTER
NY
Enumeration date
08/29/2006
Last updated
07/08/2007
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