Individual
SUSAN WETHERILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSW.FPSW,CCSS
Contact information
Practice address
1588 US HIGHWAY 84, LAS VEGAS, NM 87701-3594
(570) 921-3236
Mailing address
1588 US HIGHWAY 84, LAS VEGAS, NM 87701-3594
(570) 921-3236
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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