Individual
KELLY SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 MCDERMOTT DR # 233, WEST CHESTER, PA 19380-4022
(610) 430-5678
Mailing address
315 NEW ST APT 226, PHILADELPHIA, PA 19106-1138
(631) 848-4483
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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