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1619331840
JACK CUSATOR
RANCHO CUCAMONGA, CA
NPI
1619331840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 37701)
Enumeration Date
2016-04-13
Last Update Date
2022-02-11
Business Address
-- JACK CUSATOR LMFT; PsyD
9500 ETIWANDA AVE
RANCHO CUCAMONGA, CA 91739-9662
Phone number: 909-436-5116
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Mailing Address
-- JACK CUSATOR LMFT; PsyD
651 SUNGATE DR APT 278
CORONA, CA 92879-6598
Phone number:
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