Doctor Name: | SUZANNE BATES |
NPI Number: | 1225429327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW, CADC |
License Number: | 150.014983 |
Business Practice Address: | 11447 2nd St Ste 9b Roscoe, IL - 610739522 |
Business Phone Number: | 8156014673 |
Business Fax Number: | |
Mailing Address: | 8180 Freeport Rd, DURAND |
State: | IL |
Postal Code: | 610249719 |
Phone Number: | 8158716381 |
Fax Number: | |
NPI Enumeration Date: | 02/10/2015 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 150.014983 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |