Individual
KELLY STEVEN PIERSANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
44 N MAIN ST, MALAD CITY, ID 83252-1200
(208) 766-2389
Mailing address
2646 N 1575 E, LAYTON, UT 84040-8508
(801) 771-0332
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-4594
ID
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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