Individual
KENNETH DAVID KUSSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
48 CONIFER LN, MURPHYSBORO, IL 62966-5242
(618) 559-3342
(618) 559-3342
Mailing address
48 CONIFER LN, MURPHYSBORO, IL 62966
(618) 559-3342
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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