MEDICARE: SUZETTE FACEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor		FL

General Provider Information

NPI Number	:	1003389446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZETTE FACEY

Provider Business Mailing Address
First Line	:	2040 HAMLIN ST
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-5322
Country	:	US
Telephone Number	:	917-405-3109
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 HAMLIN ST
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-5322
Country	:	US
Telephone Number	:	917-405-3109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	01/08/2019

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Directions to “ SUZETTE FACEY ” Practice Location

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