Individual
DR. DUSTIN KIESCHNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
198 TIGER TAIL RD, OLYMPIC VALLEY, CA 96146-9783
(910) 467-3217
Mailing address
PO BOX 3221, OLYMPIC VALLEY, CA 96146-3221
(910) 467-3217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32828
CA
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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