Individual
DR. GARY MATTHEW CUSICK
Active
Individual
DR. GARY MATTHEW CUSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1344
KY
103T00000X
Psychologist
1344
KY
103TB0200X
Cognitive & Behavioral Psychologist
1344
KY
103TC0700X
Clinical Psychologist
Primary
1344
KY
103TC1900X
Counseling Psychologist
1344
KY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
1344
KY
Other
Enumeration date
12/02/2010
Last updated
10/04/2012
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