Individual
SUSAN J MCANINCH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
20 S 1ST AVE, STURGEON BAY, WI 54235-2546
(920) 746-0162
(920) 746-0140
Mailing address
20 S 1ST AVE, STURGEON BAY, WI 54235-2546
(920) 746-0162
(920) 746-0140
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6742-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43569800
—
WI
Enumeration date
01/16/2006
Last updated
07/08/2007
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