Provider Demographics
NPI:1427455203
Name:WISSLER, KAYE (LISW)
Entity type:Individual
Prefix:
First Name:KAYE
Middle Name:
Last Name:WISSLER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5982 RHODES RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4128
Mailing Address - Country:US
Mailing Address - Phone:330-673-1347
Mailing Address - Fax:339-678-3677
Practice Address - Street 1:5982 RHODES RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4128
Practice Address - Country:US
Practice Address - Phone:330-673-1347
Practice Address - Fax:339-678-3677
Is Sole Proprietor?:No
Enumeration Date:2014-11-22
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.14512191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical