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General NPI Number Information
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NPI Number | 1003337684
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Entity Type | Individual
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Provider Name | SUSI BLITMAN LMHC
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Gender | Female
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Dates
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Enumeration Date | 07/04/2017
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 2010 NW 150TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2887
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Country | US
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Telephone | 954-431-9838
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Fax | 954-779-2316
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Provider Business Mailing Address
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Address Line | 10286 HARBOR INN CT
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-5622
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Country | US
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Telephone | 954-547-3414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH15054
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License Number State | FL
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