Organization Name: | DAWN M KUSINSKI |
NPI Number: | 1013307586 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAWN KUSINSKI (PROVIDER/OWNER) |
Mailing Address: | 863 Center Ct Unit A Shorewood |
State: | IL US |
Postal Code: | 604048512 |
Phone Number: | 5054129185 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2015 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 178.009423 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |