Individual
ELLEN A SUSHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
205 VALLEY AVE, WEST BEND, WI 53095-5312
(262) 338-1123
Mailing address
1061 E COMMERCE BLVD, SLINGER, WI 53086-9326
(262) 644-2900
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2002
WI
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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