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General NPI Number Information
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NPI Number | 1083876486
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Entity Type | Individual
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Provider Name | SUZANNE E. MOSER LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | W129N7055 NORTHFIELD DR
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-0537
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Country | US
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Telephone | 414-805-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 W INNOVATION DR THIRD FLOOR
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City | MILWAUKEE
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State | WI
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Zip | 53226-4837
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Country | US
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Telephone | 414-456-5006
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Fax | 414-456-6259
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1223
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License Number State | WI
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