Individual
SANDRA L KRUSICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
1 MT CARMEL WAY, PITTSBURG, KS 66762-7587
(620) 235-7940
(620) 235-7908
Mailing address
1 MT CARMEL WAY, PITTSBURG, KS 66762-7587
(620) 235-7940
(620) 235-7908
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
193
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0193
KANSAS LICENSE
KS
Enumeration date
08/12/2011
Last updated
08/12/2011
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