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NPI Code Detail

MEDICARE: DR. DERYA SUZEN PHD

MEDICARE: DR. DERYA SUZEN PHD
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
1101YM0800XMental Health Counselor13847AZ

General Provider Information

NPI Number : 1548571300
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DERYA SUZEN PHD
Provider Business Mailing Address
First Line : 3480 E ROUTE 66
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-4032
Country : US
Telephone Number : 928-863-7333
Fax Number :
Provider Business Practice Location Address
First Line : 3480 E ROUTE 66
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-4032
Country : US
Telephone Number : 928-863-7333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2010
Last Update Date : 10/25/2016

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Directions to “ DR. DERYA SUZEN PHD” Practice Location

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