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General NPI Number Information
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NPI Number | 1952770299
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Entity Type | Individual
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Provider Name | ANJANET KIESEL MA, LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 8695 COLLEGE PKWY SUITE 2250
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City | FORT MYERS
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State | FL
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Zip | 33919-4809
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Country | US
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Telephone | 239-489-4705
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 CORAL POINT DR
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City | CAPE CORAL
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State | FL
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Zip | 33990-6832
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Country | US
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Telephone | 239-634-8280
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Fax |
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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 | MH 13521
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License Number State | FL
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