Individual
MR. DERRICK C KISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 EAST ST, EASTHAMPTON, MA 01027-1234
(774) 823-5744
Mailing address
203 EAST ST, EASTHAMPTON, MA 01027-1234
(774) 823-5744
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
S56441418
MA
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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