Individual
STACIE KUSSRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 KATALIN CT, BAY CITY, MI 48706-2160
(989) 324-2012
Mailing address
3710 KATALIN CT, BAY CITY, MI 48706-2160
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/01/2019
Last updated
06/13/2023
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