Provider Demographics
NPI:1487950911
Name:KISSEE, WILLIAM MICHAEL SR (MS, MA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:KISSEE
Suffix:SR
Gender:M
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5629 N FIGARDEN DR STE 109
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3559
Mailing Address - Country:US
Mailing Address - Phone:559-908-0742
Mailing Address - Fax:559-436-0438
Practice Address - Street 1:5629 N FIGARDEN DR STE 109
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3559
Practice Address - Country:US
Practice Address - Phone:559-908-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty