| Doctor Name: | JESSICA KAY KISLING |
| NPI Number: | 1073800637 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | CC00337 |
| Business Practice Address: | 12601 Ridgedale Dr Social Service Center, Level 2 Minnetonka, MN - 553051911 |
| Business Phone Number: | 6123487379 |
| Business Fax Number: | |
| Mailing Address: | 5412 Bernard Ave N, CRYSTAL |
| State: | MN |
| Postal Code: | 554293625 |
| Phone Number: | 6127010963 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2011 |
| NPI Last Update Date: | 07/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CC00337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |