Provider Demographics
NPI:1740849017
Name:KUSCSIK, AMY MARIE (CPST)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:KUSCSIK
Suffix:
Gender:F
Credentials:CPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 COUNTY ROAD 2000
Mailing Address - Street 2:
Mailing Address - City:JEROMASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44840-9758
Mailing Address - Country:US
Mailing Address - Phone:419-289-4825
Mailing Address - Fax:419-289-4826
Practice Address - Street 1:304 COUNTY ROAD 2000
Practice Address - Street 2:
Practice Address - City:JEROMASVILLE
Practice Address - State:OH
Practice Address - Zip Code:44840-9758
Practice Address - Country:US
Practice Address - Phone:419-289-4825
Practice Address - Fax:419-289-4826
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator