| NPI | 1205129640 |
|---|---|
| Former Name | SUZANNE MICHELE KEITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0008038-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I.0008038-SUPV) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2017-02-08 |