Provider Demographics
NPI:1134277262
Name:KESSNER, SUZANNE LYNN (PT)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:LYNN
Last Name:KESSNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:LYNN
Other - Last Name:BARBAGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4844 E ABRAHAM LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-6108
Mailing Address - Country:US
Mailing Address - Phone:480-502-3777
Mailing Address - Fax:
Practice Address - Street 1:5040 E SHEA BLVD
Practice Address - Street 2:STE. 168
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4600
Practice Address - Country:US
Practice Address - Phone:480-483-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27442251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ197279Medicaid