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Individual

DR. SUSAN DVORAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
9120 W HAMPTON AVE, SUITE 90, MILWAUKEE, WI 53225-4960
(414) 466-9777
(414) 358-5590
Mailing address
133 N 85TH ST, WAUWATOSA, WI 53226-4601
(414) 259-8938

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1423-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39094500
WI
Enumeration date
05/18/2007
Last updated
07/08/2007
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