Individual
VANESSA ANN KISSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Mailing address
1246 UNIVERSITY AVE W, 1246, SAINT PAUL, MN 55104
(763) 390-7932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
11/07/2024
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