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Individual

MRS. ANNE C KISSACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
8749 SOUTHWESTERN BLVD APT 18201, DALLAS, TX 75206-2783
(203) 710-1102
Mailing address
8749 SOUTHWESTERN BLVD APT 18201, DALLAS, TX 75206-2783
(203) 710-1102

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
78091
TX

Other

Enumeration date
05/16/2020
Last updated
05/16/2020
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