Provider Demographics
NPI:1740039601
Name:KISS, ANIKO G
Entity type:Individual
Prefix:
First Name:ANIKO
Middle Name:G
Last Name:KISS
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 1:237 E FAIRHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-1702
Mailing Address - Country:US
Mailing Address - Phone:360-941-4215
Mailing Address - Fax:
Practice Address - Street 1:237 E FAIRHAVEN AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1702
Practice Address - Country:US
Practice Address - Phone:360-941-4215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health