Provider Demographics
NPI:1144416074
Name:DICKSON, SUZANNE (PHD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:DICKSON
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:GLENS FALLS HOSPITAL - CREDENTIALING
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-5924
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:101 RIDGE STREET
Practice Address - Street 2:THE HEARING CENTER AND NEUROPSYCHOLOGY
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801
Practice Address - Country:US
Practice Address - Phone:518-926-2024
Practice Address - Fax:518-926-2079
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2024-02-08
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Provider Licenses
StateLicense IDTaxonomies
017333103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017333OtherLICENSE