Doctor Name: | MS. SUE ANN KURUZOVICH |
NPI Number: | 1073548178 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSSW |
License Number: | 6951-123 |
Business Practice Address: | 500 East Veterans Street Vamc Tomah Tomah, WI - 54660 |
Business Phone Number: | 6083721798 |
Business Fax Number: | |
Mailing Address: | 10739 State Highway 27, SPARTA |
State: | WI |
Postal Code: | 546564751 |
Phone Number: | 6082690362 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6951-123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |