Individual
SUSAN ANN COUSINEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 HIGHLAND DR, JACKSON, MI 49201-9164
(151) 774-0742
(517) 315-4918
Mailing address
3100 THORNTREE DR APT 6, GLADSTONE, MI 49837-2479
(517) 740-7422
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902003787
MI
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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