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General NPI Number Information
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NPI Number | 1689794802
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Entity Type | Individual
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Provider Name | MRS. SUZANNE RUTH AUTH
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3543A HIGHWAY 93
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City | TWIN FALLS
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State | ID
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Zip | 83301-0465
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Country | US
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Telephone | 208-731-7832
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Fax | 208-734-2613
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Provider Business Mailing Address
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Address Line | 3543A HIGHWAY 93
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City | TWIN FALLS
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State | ID
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Zip | 83301-0465
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Country | US
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Telephone | 208-731-7832
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Fax | 208-734-2613
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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