Doctor Name: | DR. SUZANNE MICHELE DUGAN |
NPI Number: | 1114098662 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY12909 |
Business Practice Address: | 3201 N Sepulveda Blvd Suite C Manhattan Beach, CA - 902662463 |
Business Phone Number: | 3105461213 |
Business Fax Number: | 3103121667 |
Mailing Address: | 3201 N Sepulveda Blvd, Suite C MANHATTAN BEACH |
State: | CA |
Postal Code: | 902662463 |
Phone Number: | 3105461213 |
Fax Number: | 3103121667 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PSY12909 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |