Provider Demographics
NPI:1831138718
Name:KUSZMAUL, DEBRA MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:KUSZMAUL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:MARIE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27550 SCHOOL SECTION RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-3833
Mailing Address - Country:US
Mailing Address - Phone:586-295-9704
Mailing Address - Fax:248-605-3525
Practice Address - Street 1:13001 23 MILE RD STE 103
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2767
Practice Address - Country:US
Practice Address - Phone:586-295-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009324101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor