Doctor Name: | SUSAN YAP LASSITER |
NPI Number: | 1164416970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 3684 |
Business Practice Address: | 288 N Ironwood Dr 110 Apache Junction, AZ - 852203830 |
Business Phone Number: | 4809822356 |
Business Fax Number: | |
Mailing Address: | 7452 E Kiowa Ave, MESA |
State: | AZ |
Postal Code: | 852096239 |
Phone Number: | 4802506602 |
Fax Number: | |
NPI Enumeration Date: | 09/07/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3684 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |