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NPI Code Detail

MEDICARE: SUZANNE PAMELA DEMIER PSYD

MEDICARE: SUZANNE PAMELA DEMIER PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPY01642MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1113666OTHERMOBLUE SHIELD

General Provider Information

NPI Number : 1013043033
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE PAMELA DEMIER PSYD
Provider Business Mailing Address
First Line : 1423 N JEFFERSON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-1917
Country : US
Telephone Number : 417-269-3465
Fax Number : 417-269-8189
Provider Business Practice Location Address
First Line : 1423 N JEFFERSON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65802-1917
Country : US
Telephone Number : 417-269-6891
Fax Number : 417-269-5595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 02/22/2026

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Directions to “ SUZANNE PAMELA DEMIER PSYD” Practice Location

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