Individual
DEONDRAE TYSHAWN CISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 N GUIGNARD DR, SUMTER, SC 29150-1519
(803) 580-6511
Mailing address
1175 N GUIGNARD DR, SUMTER, SC 29150-1519
(803) 580-6511
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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