Individual
JOHN J KISH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3660 ROME DR, LAFAYETTE, IN 47905-4488
(765) 446-9394
(765) 447-8875
Mailing address
2493 GALA CT, WEST LAFAYETTE, IN 47906
(765) 446-9394
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004560A
IN
Other
Enumeration date
08/29/2006
Last updated
04/08/2014
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