Individual
KALEB W CUSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
245 MOUNT ROSE ST, RENO, NV 89509-3355
(775) 448-6828
Mailing address
114 BELL ST, RENO, NV 89503-5618
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY1187
NV
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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