Provider Demographics
NPI:1144438813
Name:WILUSZ, KATHRYN H (MS, BA)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:H
Last Name:WILUSZ
Suffix:
Gender:F
Credentials:MS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ABINGTON
Mailing Address - Street 2:
Mailing Address - City:MURROE
Mailing Address - State:COUNTY LIMERICK
Mailing Address - Zip Code:000000
Mailing Address - Country:IE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 MALLOW STREET
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:LIMERICK
Practice Address - Zip Code:000000
Practice Address - Country:IE
Practice Address - Phone:0113536-140-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist