Provider Demographics
NPI:1639259617
Name:SCHRAMKA, SUSAN SCHOENDORF (PSY D)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:SCHOENDORF
Last Name:SCHRAMKA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 N HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3340
Mailing Address - Country:US
Mailing Address - Phone:414-264-7748
Mailing Address - Fax:
Practice Address - Street 1:741 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4820
Practice Address - Country:US
Practice Address - Phone:262-542-3255
Practice Address - Fax:262-542-0823
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2511-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40956300Medicare ID - Type Unspecified