GAVIN DAVID KISEBACH

LACEY, WA
NPI1265210835
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2023-09-15
Last Update Date2023-09-15
Business Address
GAVIN DAVID KISEBACH
1034 ANNETTE CT SE
LACEY, WA 98503-1824
Phone number: 360-791-5826
Mailing Address
GAVIN DAVID KISEBACH
1034 ANNETTE CT SE
LACEY, WA 98503-1824
Phone number: 360-791-5826