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Individual

CARA MCCUSKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LBS

Contact information

Practice address
10541 DRUMMOND RD, PHILADELPHIA, PA 19154-3807
(215) 612-7625
Mailing address
3557 BROOKVIEW RD, PHILADELPHIA, PA 19154-4035

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003432
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000013500321
PA
Enumeration date
08/28/2017
Last updated
08/28/2017
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