| Susan Wasserman Llc | |
|
2932 N Hackett Ave Milwaukee WI 53211-3442 | |
| (414) 961-0649 | |
| Not Available |
| Full Name | Susan Wasserman Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2932 N Hackett Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Susan Wasserman (OWNER) |
| Authorized Official Contact | 4149610649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Wasserman Llc 2932 N Hackett Ave Milwaukee WI 53211-3442 Ph: () - | Susan Wasserman Llc 2932 N Hackett Ave Milwaukee WI 53211-3442 Ph: (414) 961-0649 |
| NPI Number | 1477877595 |
|---|---|
| Provider Enumeration Date | 03/18/2010 |
| Last Update Date | 03/18/2010 |
| Medicare PECOS PAC ID | 1557553328 |
|---|---|
| Medicare Enrollment ID | O20101012000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477877595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 426-123 (Wisconsin) | Primary |
| Provider Name | Susan Wasserman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871652230 PECOS PAC ID: 3870641236 Enrollment ID: I20090423000487 |
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