Most Relevant Information
Provider Data
| NPI Number: | 1003320243 |
| Provider Name: | KENNETH DAVID KUSSIN |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/27/2017 |
| Last Updated: | 11/27/2017 |
Provider Practice Location
48 CONIFER LN
MURPHYSBORO
IL
629665242
Practice Location Phone/Fax
| Phone: | 6185593342 |
| Fax: | 6185593342 |
Provider Mailing Location
48 CONIFER LN
MURPHYSBORO
IL
62966
Provider Mailing Phone/Fax
| Phone: | 6185593342 |
| Fax: |