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General NPI Number Information
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NPI Number | 1174691950
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Entity Type | Individual
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Provider Name | DEBRA SUSKIN GION LPC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 04/27/2014
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Provider Practice Location Address
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Address Line | 21300 N JOHN WAYNE PKWY SUITE 120
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City | MARICOPA
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State | AZ
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Zip | 85139-8979
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Country | US
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Telephone | 520-858-6262
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Fax | 480-839-0197
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Provider Business Mailing Address
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Address Line | PO BOX 12706
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City | TEMPE
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State | AZ
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Zip | 85284-0046
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Country | US
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Telephone | 520-858-6262
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Fax | 480-839-0197
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-#0277
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License Number State | AZ
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