Organization
SUSAN POWERS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN POWERS MD (PRESIDENT)
(414) 771-1639
Entity
Organization
Contact information
Practice address
10125 W NORTH AVE, WAUWATOSA, WI 53226-2426
(414) 771-1639
(414) 536-8605
Mailing address
10125 W NORTH AVE, WAUWATOSA, WI 53226-2426
(414) 771-1639
(414) 536-8605
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180610
VALUEOPTIONS PROVIDER
WI
Enumeration date
04/17/2007
Last updated
08/22/2020
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