Individual
SUSAN E SISKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
419 E 7TH ST STE 207, THE DALLES, OR 97058-2676
(541) 296-5452
(541) 296-4792
Mailing address
419 E 7TH ST STE 207, THE DALLES, OR 97058-2676
(541) 296-5452
(541) 296-4792
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2188
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139670
—
OR
Enumeration date
12/17/2008
Last updated
12/17/2008
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