Individual
SAMANTHA FAYE KUSPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, CD, LD
Contact information
Practice address
890 ELM GROVE RD STE 100, ELM GROVE, WI 53122-2528
(262) 352-6050
Mailing address
890 ELM GROVE RD STE 100, ELM GROVE, WI 53122-2528
(262) 352-6050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86063505
WI
Other
Enumeration date
11/13/2017
Last updated
04/29/2024
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