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Individual

MRS. KIMBERLY DAWN KUCSIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
(573) 365-2224
Mailing address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
(573) 365-2224

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW005728
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3404547
NC
Enumeration date
10/13/2009
Last updated
10/13/2009
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