Individual
ANDREW MARK KISELICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
701 S 5TH ST, CLARK HALL RM 501, COLUMBIA, MO 65211-0001
(573) 882-1561
(573) 884-1889
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2020008417
MO
Other
Enumeration date
07/16/2020
Last updated
10/05/2022
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