| Doctor Name: | MRS. KISA ROBERTS |
| NPI Number: | 1811121650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, PLPC |
| License Number: | 2009009851 |
| Business Practice Address: | 13160 Cr 3610 St James, MO - 65559 |
| Business Phone Number: | 5732653251 |
| Business Fax Number: | |
| Mailing Address: | Po Box 189, SAINT JAMES |
| State: | MO |
| Postal Code: | 655590189 |
| Phone Number: | 5732653251 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 12/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2009009851 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |