| Doctor Name: | MS. SUZANNE MARIE GANSCHOW |
| NPI Number: | 1073547238 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC., CCAP |
| License Number: | 1053 |
| Business Practice Address: | 1600 Broad Ave Gulfport, MS - 395013603 |
| Business Phone Number: | 2288631132 |
| Business Fax Number: | 2288651700 |
| Mailing Address: | 3117 N 9th St, OCEAN SPRINGS |
| State: | MS |
| Postal Code: | 395641055 |
| Phone Number: | 2288756364 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 01/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1053 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |