Doctor Name: | MRS. SUSAN SPRINGSTUBE |
NPI Number: | 1447507686 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1349-226 |
Business Practice Address: | 117 B Gardner St Two Rivers, WI - 542413205 |
Business Phone Number: | 9206292074 |
Business Fax Number: | |
Mailing Address: | 117 B Gardner Street, TWO RIVERS |
State: | WI |
Postal Code: | 54241 |
Phone Number: | 9206292074 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2012 |
NPI Last Update Date: | 08/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1349-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |