Provider Demographics
NPI:1467512426
Name:RISH, SALLI ELISA
Entity Type:Individual
Prefix:
First Name:SALLI
Middle Name:ELISA
Last Name:RISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 GREGG HWY
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6341
Mailing Address - Country:US
Mailing Address - Phone:803-641-7720
Mailing Address - Fax:803-641-7248
Practice Address - Street 1:951 MILLBROOK AVE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6526
Practice Address - Country:US
Practice Address - Phone:803-641-7720
Practice Address - Fax:803-641-7248
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health