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1043644636
JASON R CUSSEN
FORT WAYNE, IN
NPI
1043644636
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 39002779A)
Enumeration Date
2013-08-30
Last Update Date
2024-05-25
Business Address
JASON R CUSSEN MA
12743 SLASH PASS
FORT WAYNE, IN 46818-0063
Phone number: 260-345-7990
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Mailing Address
JASON R CUSSEN MA
12743 SLASH PASS
FORT WAYNE, IN 46818-0063
Phone number: 260-345-7990
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