Individual
MRS. SUSAN MERCY HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(254) 220-5528
Mailing address
505 ALYSSA ST, TOMAH, WI 54660-8197
(254) 220-5528
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9503-123
WI
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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