Provider Demographics
NPI:1427451293
Name:KATHERINE KUSNER, PH.D.,LLC
Entity type:Organization
Organization Name:KATHERINE KUSNER, PH.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-242-8597
Mailing Address - Street 1:5729 SHAGBARK DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-9554
Mailing Address - Country:US
Mailing Address - Phone:734-646-2716
Mailing Address - Fax:
Practice Address - Street 1:5729 SHAGBARK DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-9554
Practice Address - Country:US
Practice Address - Phone:734-646-2716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015763103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty