Individual
AMANDA L KISEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LBS, LSW
Contact information
Practice address
14 BROOKSIDE RD, WAYMART, PA 18472-9353
(570) 540-3957
Mailing address
14 BROOKSIDE RD, WAYMART, PA 18472-9353
(570) 540-3957
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW141253
PA
251S00000X
Community/Behavioral Health Agency
BH005106
PA
Other
Enumeration date
04/18/2023
Last updated
03/01/2024
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