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Individual

MRS. KELLY SISSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
407 4TH AVE SW, ZEELAND, ND 58581-4047
(701) 595-5789
Mailing address
PO BOX 155, ZEELAND, ND 58581-0155
(701) 595-5789

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149016432
IL
1041C0700X
Clinical Social Worker
Primary
4978
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143053
ND
Enumeration date
01/27/2014
Last updated
05/19/2023
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