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General NPI Number Information
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NPI Number | 1295920692
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Entity Type | Individual
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Provider Name | SUSAN M. DAUBENBIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2942 N 24TH ST SUITE 114
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City | PHOENIX
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State | AZ
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Zip | 85016-7844
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Country | US
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Telephone | 602-550-8101
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Fax | 602-995-7290
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Provider Business Mailing Address
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Address Line | 2101 W PALMAIRE AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-7742
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Country | US
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Telephone | 602-550-8101
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Fax | 602-995-7290
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW2599
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License Number State | AZ
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