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General NPI Number Information
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NPI Number | 1902887268
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Entity Type | Organization
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Legal Business Name | SUZANNE K. ZOSS, PH.D., P.A.
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Dates
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Enumeration Date | 11/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4300 BAYOU BLVD SUITE 35
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City | PENSACOLA
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State | FL
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Zip | 32503-1949
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Country | US
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Telephone | 850-479-6080
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Fax | 850-479-3011
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Provider Business Mailing Address
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Address Line | 1115 WATSON AVE
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City | PENSACOLA
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State | FL
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Zip | 32503-6573
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Country | US
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Telephone | 850-291-2568
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Fax | 850-435-7796
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUZANNE K. ZOSS
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Credential | PH.D.
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Telephone | 850-291-2568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 3413
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License Number State | FL
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