Individual
MRS. SUSAN M DRIEFKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 524-7903
(608) 524-7977
Mailing address
PO BOX 29, BARABOO, WI 53913-0029
(608) 524-7903
(608) 524-7977
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
03K00000X
WI
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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