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Individual

MS. SUSAN SALLY ASHTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSW

Contact information

Practice address
2100 CHURCH STREET, EAST TROY, WI 53120-0621
(262) 642-5080
(262) 643-4393
Mailing address
1922 DEER PATH, WAUKESHA, WI 53189-8221
(262) 549-5153

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10123
LICENSE NUMBER AS LCSW
WI
05
39269800
WI
Enumeration date
01/22/2007
Last updated
07/08/2007
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