Provider Demographics
NPI:1134557077
Name:NOVAK, SUSAN (BA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:NOVAK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 ARDENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1301
Mailing Address - Country:US
Mailing Address - Phone:330-414-4955
Mailing Address - Fax:
Practice Address - Street 1:2303 ARDENDALE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1301
Practice Address - Country:US
Practice Address - Phone:330-414-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker