Individual
WENDY BULTHUIS-SUSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 N COLFAX ST, BYRON, IL 61010-1438
(815) 234-2722
Mailing address
417 N COLFAX ST, BYRON, IL 61010-1438
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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