Individual
LAURA ANN KISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3550 CONCORD RD, YORK, PA 17402-8626
(717) 851-6340
(717) 851-6349
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3026
(717) 851-6816
(717) 851-6892
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018096
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103225203
—
PA
Enumeration date
08/22/2012
Last updated
03/23/2017
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