Provider Demographics
NPI:1972658656
Name:ARNOLD, SUZANNE AMIEE (BS)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:AMIEE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:AMIEE
Other - Last Name:KOBERSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:500 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3632
Mailing Address - Country:US
Mailing Address - Phone:262-548-7348
Mailing Address - Fax:262-548-7643
Practice Address - Street 1:500 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3632
Practice Address - Country:US
Practice Address - Phone:262-548-7348
Practice Address - Fax:262-548-7643
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3929-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker