Individual
SUSAN LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 437-3540
Mailing address
300 CROOKS STREET, PO BOX 22308, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 437-3540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2460123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39221900
—
WI
Enumeration date
10/05/2006
Last updated
06/04/2009
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