Individual
JESSICA KAY KISLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
12601 RIDGEDALE DR, SOCIAL SERVICE CENTER, LEVEL 2, MINNETONKA, MN 55305-1911
(612) 348-7379
Mailing address
5412 BERNARD AVE N, CRYSTAL, MN 55429-3625
(612) 701-0963
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC00337
MN
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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