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NPI Code Detail

MEDICARE: MS. SUZAN PAULA PATALANO MSW,LCSW

MEDICARE:  MS. SUZAN PAULA PATALANO  MSW,LCSW
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
11041C0700XClinical Social WorkerLCSW - 0177AZ

General Provider Information

NPI Number : 1548486475
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZAN PAULA PATALANO MSW,LCSW
Provider Business Mailing Address
First Line : 1717 E TUCKEY LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-1333
Country : US
Telephone Number : 602-294-0380
Fax Number :
Provider Business Practice Location Address
First Line : 4612 N 28TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4931
Country : US
Telephone Number : 602-764-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ MS. SUZAN PAULA PATALANO MSW,LCSW” Practice Location

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