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Individual

SONDRA LYNN KISSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
600 SE 4TH ST, CLARE, MI 48617-9201
(989) 386-7723
Mailing address
20668 HIBMA RD, TUSTIN, MI 49688-8241
(814) 248-9144

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3658528
MI

Other

Enumeration date
10/07/2014
Last updated
10/07/2014
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