Individual
MS. SUSAN C ENDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ATRL BC
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
69036
WI
221700000X
Art Therapist
69036
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41001000
—
WI
Enumeration date
05/01/2007
Last updated
09/11/2025
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