Individual
SUSAN KATHERINE ANNE DE SHAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CLT, MLD
Contact information
Practice address
608 NORTH AVE, SHEBOYGAN, WI 53083-4933
(262) 365-8958
Mailing address
608 NORTH AVE, SHEBOYGAN, WI 53083-4933
(262) 365-8958
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11297-146
WI
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/07/2012
Last updated
08/01/2024
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