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Individual
MR. MARK RONALD KISNER
Active
Individual
MR. MARK RONALD KISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, CADC-II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RA851306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RA851306
CERTIFICATION BOARD OF ALCOHOL AND DRUG COUNSELORS
CA
Enumeration date
09/09/2008
Last updated
09/09/2008
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