Doctor Name: | MS. SUSAN QUEENEY DRISCOLL |
NPI Number: | 1174689327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LC0981 |
Business Practice Address: | 19510 Club House Rd Montgomery Village, MD - 208863002 |
Business Phone Number: | 3019774536 |
Business Fax Number: | |
Mailing Address: | 9316 Judge Pl, MONTGOMERY VILLAGE |
State: | MD |
Postal Code: | 208863129 |
Phone Number: | 3018696724 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LC0981 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |