Individual
MS. SUSAN MARIE PANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT LCSW
Contact information
Practice address
811 60TH ST, 2E, KENOSHA, WI 53140-4074
(262) 652-9599
(262) 652-0009
Mailing address
PO BOX 96, KENOSHA, WI 53141-0096
(262) 652-9599
(262) 652-0009
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2606-123
WI
106H00000X
Marriage & Family Therapist
Primary
558-124
WI
Other
Enumeration date
04/05/2007
Last updated
09/14/2010
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