Provider Demographics
NPI:1548956436
Name:BROWN, SUZANNA L (MA, PLCP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, PLCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N PINE ST # 105C
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-3141
Mailing Address - Country:US
Mailing Address - Phone:573-240-2038
Mailing Address - Fax:808-758-5890
Practice Address - Street 1:901 N PINE ST # 105C
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-3141
Practice Address - Country:US
Practice Address - Phone:573-240-2038
Practice Address - Fax:808-758-5890
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional