Healthcare Provider Details

I. General information

NPI: 1558733725
Provider Name (Legal Business Name): SUZAN PLOWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 HIGHLAND AVE BUILDING A, SUITE 6
CHESHIRE CT
06410-2525
US

IV. Provider business mailing address

408 HIGHLAND AVE BUILDING A, SUITE 6
CHESHIRE CT
06410-2525
US

V. Phone/Fax

Practice location:
  • Phone: 860-483-0781
  • Fax:
Mailing address:
  • Phone: 860-483-0781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: