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1003113390
KELLY STEVEN PIERSANTI
MALAD CITY, ID
NPI
1003113390
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC-4594)
Enumeration Date
2011-02-22
Last Update Date
2011-02-22
Business Address
-- KELLY STEVEN PIERSANTI LPC
44 N MAIN ST
MALAD CITY, ID 83252-1200
Phone number: 208-766-2389
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Mailing Address
-- KELLY STEVEN PIERSANTI LPC
2646 N 1575 E
LAYTON, UT 84040-8508
Phone number: 801-771-0332
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