Kip Cameron Kussman, B.A.
Counselor, Addiction (Substance Use Disorder) in Milwaukee, WI. Individual provider (NPI-1).
NPI number1619110012
StatusActive
Last updated in NPPESApr 14, 2009
Details
- NPI
- 1619110012
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kip Cameron Kussman
- Credential
- B.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 14, 2009
- Last updated
- Apr 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 15775-130 | WI | Yes |
Practice location
561 N 15th St171a
Milwaukee, WI 53233-2237
Phone 414-288-4556
Mailing address
561 N 15th St171a
Milwaukee, WI 53233-2237
Phone 414-288-4556
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