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Individual

KENNETH HOWARD SUSSKIND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.W.

Contact information

Practice address
441 MAIN STREET, KEENE, NH 03431
(603) 209-7885
Mailing address
81 TERRACE STREET, KEENE, NH 03431
(603) 357-3285

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1161
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30423240
NH
Enumeration date
05/01/2007
Last updated
07/08/2007
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