Healthcare Provider Details

I. General information

NPI: 1326430521
Provider Name (Legal Business Name): SUSAN SABOGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7853 COLONY LAKE DR
BOYNTON BEACH FL
33436-1303
US

IV. Provider business mailing address

7853 COLONY LAKE DR
BOYNTON BEACH FL
33436-1303
US

V. Phone/Fax

Practice location:
  • Phone: 561-318-3628
  • Fax:
Mailing address:
  • Phone: 561-318-3628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27866
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: