| NPI | 1447585476 |
|---|---|
| Former Name | SUZANNE MARIE CLEVERINGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 001195) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103T00000X Psychologist (Licence: NE 826) | |
| 103TH0100X Psychologist Health Service (Licence: IA 000558) | |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2020-02-04 |