Individual
BRYANT JUDSON KUSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1243 E IRON EAGLE DR STE 130D, EAGLE, ID 83616-6599
(208) 391-7050
Mailing address
1243 E IRON EAGLE DR STE 130D, EAGLE, ID 83616-6599
(208) 391-7050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5488
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61806854
—
NM
Enumeration date
01/19/2011
Last updated
06/05/2023
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