Individual
KELLY PAOLISSO
Active
Individual
KELLY PAOLISSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
290846347
AZ
225100000X
Physical Therapist
Primary
10640PT
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
875966
—
AZ
Enumeration date
01/16/2007
Last updated
10/29/2015
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