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Individual

SUSAN KLINGER WALLOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSW LCSW

Contact information

Practice address
711 N BRIDGE STREET, RM 122, CHIPPEW FALLS, WI 54729-1876
(715) 726-7788
(715) 726-4560
Mailing address
711 N BRIDGE STREET, RM 122, CHIPPEW FALLS, WI 54729-1876
(715) 726-7788
(715) 726-4560

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
422 123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17950
SECURITY HEALTH
WI
05
39576300
WI
Enumeration date
11/17/2006
Last updated
07/08/2007
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