Individual
SUZANNE L KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
1500 MCANDREWS RD W STE 223, BURNSVILLE, MN 55337-4445
(952) 854-7771
Mailing address
1500 MCANDREWS RD W STE 223, BURNSVILLE, MN 55337-4445
(952) 854-7771
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3833
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
670522700
—
MN
Enumeration date
11/17/2005
Last updated
03/18/2024
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