Basic Information
| Provider Information | |||||||||
| NPI: | 1922463421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KISER | ||||||||
| FirstName: | MARNIE | ||||||||
| MiddleName: | KELLUM | ||||||||
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| Credential: | LPCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 19113 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288151113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282980186 | ||||||||
| FaxNumber: | 8282984870 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 REDDICK RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288052717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282980186 | ||||||||
| FaxNumber: | 8282984870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2015 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 12073 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.