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General NPI Number Information
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NPI Number | 1154112944
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Entity Type | Individual
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Provider Name | GABRIELLE KISSI
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 6650 BROWNING RD RM U14
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City | PENNSAUKEN
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State | NJ
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Zip | 08109-1479
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Country | US
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Telephone | 856-831-7000
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Fax | 856-831-4991
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Provider Business Mailing Address
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Address Line | 1901 N OLDEN AVENUE EXT STE 29
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City | EWING
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State | NJ
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Zip | 08618-2111
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Country | US
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Telephone | 609-237-7100
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Fax | 609-616-7904
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SL07195700
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License Number State | NJ
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