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1528405511
MATTHEW KAPUSTIANYK
DEKALB, IL
NPI
1528405511
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL 25768)
Enumeration Date
2013-05-30
Last Update Date
2013-05-30
Business Address
-- MATTHEW KAPUSTIANYK CADC
12 HEALTH SERVICES DR
DEKALB, IL 60115-9637
Phone number: 815-756-4875
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Mailing Address
-- MATTHEW KAPUSTIANYK CADC
12 HEALTH SERVICES DR
DEKALB, IL 60115-9637
Phone number: 815-756-4875
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