Matzke, Susan M

Matzke, Susan M is an individual health care provider with primary practice located at 1 S Main St , Janesville WI 53545-3922. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Matzke, Susan M can be contacted via phone (608) 757-0404.

Contact Information

Primary practice address
1 S Main St Janesville WI 53545-3922
Phone: (608) 757-0404
Fax: (608) 757-2319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 463-125 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3327-123 Wisconsin

Profile Details

NPI number 1689640401
LBN Legal business name Matzke, Susan M
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689640401 NPPES
Wisconsin MEDICAID 39196700

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