Individual
KELLY SISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1135 BROAD ST, CLIFTON, NJ 07013-3346
(973) 470-8687
Mailing address
1135 BROAD ST, CLIFTON, NJ 07013-3346
(973) 470-8687
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
025749
NY
235Z00000X
Speech-Language Pathologist
Primary
41YS00800400
NJ
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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