Individual
SUSAN NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12973-137
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12973-137
LICENSE NUMBER
WI
Enumeration date
12/13/2007
Last updated
12/13/2007
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