| NPI | 1265595755 |
|---|---|
| Former Name | SUZANNE RIVERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701005166) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ lpc2323) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2013-12-12 |