KIP CAMERON KUSSMAN

MILWAUKEE, WI
NPI1619110012
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  15775-130)
Enumeration Date2009-04-14
Last Update Date2009-04-14
Business Address
Mr. KIP CAMERON KUSSMAN B.A.
561 N 15TH ST 171A
MILWAUKEE, WI 53233-2237
Phone number: 414-288-4556
Mailing Address
Mr. KIP CAMERON KUSSMAN B.A.
561 N 15TH ST 171A
MILWAUKEE, WI 53233-2237
Phone number: 414-288-4556
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