Provider Demographics
NPI:1003166315
Name:DIJULIO, SUSAN (MED , LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:DIJULIO
Suffix:
Gender:F
Credentials:MED , LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3814
Mailing Address - Country:US
Mailing Address - Phone:334-821-3005
Mailing Address - Fax:
Practice Address - Street 1:311 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3814
Practice Address - Country:US
Practice Address - Phone:334-821-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional