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Individual

ETHAN L KISER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
E.2606146

Contact information

Practice address
1205 BROADWAY, LORAIN, OH 44052-3409
(440) 240-1655
Mailing address
1205 BROADWAY, LORAIN, OH 44052-3409
(440) 240-1655

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.2103674-TRNE
OH
101Y00000X
Counselor
Primary
E.2606146
OH

Other

Enumeration date
12/15/2021
Last updated
01/16/2026
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