Provider Demographics
NPI:1457567505
Name:NELMS, SUSAN LEE (RN, BS, MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEE
Last Name:NELMS
Suffix:
Gender:F
Credentials:RN, BS, MA, LMFT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:LEE
Other - Last Name:WOODHOUSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:1129 26 3/4 AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-9674
Mailing Address - Country:US
Mailing Address - Phone:715-790-9419
Mailing Address - Fax:
Practice Address - Street 1:1129 26 3/4 AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:WI
Practice Address - Zip Code:54829-9674
Practice Address - Country:US
Practice Address - Phone:715-790-9419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist