Individual
MRS. STACY NICOLE KISOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5516 S FORT APACHE RD STE 130, LAS VEGAS, NV 89148-7679
(702) 641-8255
Mailing address
5516 S FORT APACHE RD STE 130, LAS VEGAS, NV 89148-7679
(702) 641-8255
(702) 399-8255
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SI 60298212
WA
Other
Enumeration date
12/14/2012
Last updated
02/26/2020
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