| Doctor Name: | MR. HENRI ANDRE SUISSA |
| NPI Number: | 1083841548 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, BCD |
| License Number: | SW 5708 |
| Business Practice Address: | 1061 Harmon Avevue Ste 1d03 Ft Stewart, GA - 313145674 |
| Business Phone Number: | 9124356933 |
| Business Fax Number: | |
| Mailing Address: | 1061 Harmon Avevue, Ste 1d03 FT STEWART |
| State: | GA |
| Postal Code: | 313145674 |
| Phone Number: | 9124356933 |
| Fax Number: | |
| NPI Enumeration Date: | 06/11/2009 |
| NPI Last Update Date: | 06/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW 5708 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |