Doctor Name: | SUZANNE MARY SERBUS |
NPI Number: | 1336571074 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW LICSW |
License Number: | 2155 |
Business Practice Address: | 108 S Minnesota Ave Ste 200 Saint Peter, MN - 560822559 |
Business Phone Number: | 5079348573 |
Business Fax Number: | 5079319562 |
Mailing Address: | 108 S Minnesota Ave Ste 200, SAINT PETER |
State: | MN |
Postal Code: | 560822559 |
Phone Number: | 5079348573 |
Fax Number: | 5079319562 |
NPI Enumeration Date: | 08/05/2013 |
NPI Last Update Date: | 08/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2155 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |