Doctor Name: | SUSAN MURRELL |
NPI Number: | 1033121256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | LISAC-10038 |
Business Practice Address: | 2187 N Vickey St Flagstaff, AZ - 860046106 |
Business Phone Number: | 9287146401 |
Business Fax Number: | 9287146480 |
Mailing Address: | 2187 N Vickey St, FLAGSTAFF |
State: | AZ |
Postal Code: | 860046106 |
Phone Number: | 9287146401 |
Fax Number: | 9287146480 |
NPI Enumeration Date: | 08/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LISAC-10038 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |