Individual
MS. JESSICA JOAN SUHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCW
Contact information
Practice address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
(262) 789-1191
(262) 821-6180
Mailing address
4044 S 76TH ST, MILWAUKEE, WI 53220-2323
(414) 791-6961
(262) 821-6180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
343-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012920001
MEDICARE PTAN WPS WISCONSIN - GREENFIELD OFFICE
WI
05
—
39557900
—
WI
05
—
42170300
—
WI
Enumeration date
03/23/2006
Last updated
03/17/2018
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