Individual
SUSAN EMILY WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2714 SMALLHOUSE RD, BOWLING GREEN, KY 42104-4350
(541) 829-8218
Mailing address
2714 SMALLHOUSE RD, BOWLING GREEN, KY 42104-4350
(541) 829-8218
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
298476
KY
Other
Enumeration date
02/20/2025
Last updated
12/17/2025
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