Paul Lynn Susic in Dardenne Prairie - Health Service
Paul Lynn Susic - NPI 1790707123
Paul Lynn Susic is a Health Service in Dardenne Prairie, Missouri. Paul Lynn Susic practices all healthcare services and medical treatments related to Health Service. The NPI Number for Paul Lynn Susic is 1790707123. The last update date is 2007-07-08.
Paul Lynn Susic's current location address is 350 Trailhead Way, Dardenne Prairie, Missouri. You can contact this provider via phone number 6363009922. The mailing address for Paul Lynn Susic is 350 Trailhead Way, Dardenne Prairie, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Paul Lynn Susic |
|---|---|
| Address | 350 Trailhead Way, Dardenne Prairie, Missouri |
| Phone Number | 6363009922 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MA |
NPI Number Detail
| NPI Number | 1790707123 |
|---|---|
| Provider Enumeration Date | 2006-07-24 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 350 Trailhead Way |
|---|---|
| City | Dardenne Prairie |
| State | Missouri (MO) |
| Post Code | 63368 |
| Phone Number | 6363009922 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Health Service |
|---|---|
| Taxonomy | 103Th0100X |
| Licence No | 1802 |
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Definition: A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustm |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Paul Lynn Susic?
The Paul Lynn Susic has been issued the NPI (National Provider Identifier) 1790707123 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Paul Lynn Susic is physically located?
The Paul Lynn Susic is situated at the following address: 350 Trailhead Way, Dardenne Prairie, MO 63368.
What is Paul Lynn Susic's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Paul Lynn Susic is Health Service, and the taxonomy classification code that categorizes this area of expertise is 103Th0100X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1790707123 to Paul Lynn Susic?
The Centers for Medicare & Medicaid Services originally issued the 1790707123 to Paul Lynn Susic on 2006-07-24.
As of what date were the Paul Lynn Susic's details last updated?
The information pertaining to the Paul Lynn Susic, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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