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General NPI Number Information
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NPI Number | 1053591354
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Entity Type | Individual
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Provider Name | SUSAN EILEEN DONAHOO PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 660 WOELFEL RD
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City | BROOKFIELD
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State | WI
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Zip | 53045-2927
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Country | US
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Telephone | 262-789-8089
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Fax |
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Provider Business Mailing Address
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Address Line | 139 W. RAND RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3985
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Country | US
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Telephone | 847-259-8583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2665-057
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License Number State | WI
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