Individual
AUTUMN KUESPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
3220 E JEFFERSON BLVD, SOUTH BEND, IN 46615-3028
(574) 222-2466
Mailing address
1710 STOCKER PL, SOUTH BEND, IN 46628-3254
(574) 276-7854
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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