Healthcare Provider Details

I. General information

NPI: 1942440060
Provider Name (Legal Business Name): SUSAN ARDEN COTE L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11726 MAJOR TURNER RUN
PARRISH FL
34219-1236
US

IV. Provider business mailing address

11726 MAJOR TURNER RUN
PARRISH FL
34219-1236
US

V. Phone/Fax

Practice location:
  • Phone: 973-432-0746
  • Fax:
Mailing address:
  • Phone: 973-432-0746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW12050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: