Provider Demographics
NPI:1962549485
Name:SUZUKI, LINDA HARUKO
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:HARUKO
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:HARUKO
Other - Last Name:SUZUKI LAUGHLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:39 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3525
Mailing Address - Country:US
Mailing Address - Phone:508-788-3681
Mailing Address - Fax:
Practice Address - Street 1:691 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 9 AND SUITE 12
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4905
Practice Address - Country:US
Practice Address - Phone:781-646-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW1073101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000P05845OtherBLUE CROSS BLUE SHIELD
MA70010000P05845OtherBLUE CROSS BLUE SHIELD