NPI 1417617911

Trey a Kissack

Practitioner Community/Behavioral Health Agency Grand Island, NE

Practice location

Address: 1811 W. 2nd Street, Suite 450, Grand Island, NE 68803-5473
Phone: (308) 379-8619
Fax: (308) 675-2690

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Nebraska →

Registry record

NPI: 1417617911
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Dec 2021
Record last updated: 23 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.