KELLY ANN ANTISTA SULTAN

SAN LUIS OBISPO, CA
NPI1124252077
Former NameKELLY ANN ANTISTA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
Enumeration Date2009-05-06
Last Update Date2015-08-13
Business Address
KELLY ANN ANTISTA SULTAN
3765 S HIGUERA ST STE 100
SAN LUIS OBISPO, CA 93401-1570
Phone number: 805-781-3535
Mailing Address
KELLY ANN ANTISTA SULTAN
1828 FIXLINI ST. APT B
SAN LUIS OBISPO, CA 93401
Phone number: 805-602-0733
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