Provider Demographics
NPI:1275122368
Name:ISAMAN, KINSLEE ELIZABETH (BACHELOR'S DEGREE)
Entity Type:Individual
Prefix:
First Name:KINSLEE
Middle Name:ELIZABETH
Last Name:ISAMAN
Suffix:
Gender:F
Credentials:BACHELOR'S DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PROMENADE PKWY APT 325
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-1285
Mailing Address - Country:US
Mailing Address - Phone:425-308-4701
Mailing Address - Fax:
Practice Address - Street 1:555 PROMENADE PKWY APT 325
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-1285
Practice Address - Country:US
Practice Address - Phone:425-308-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician