Provider Demographics
NPI:1023579810
Name:CAMPFIELD, SUZZIE
Entity Type:Individual
Prefix:MRS
First Name:SUZZIE
Middle Name:
Last Name:CAMPFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 S 36TH ST APT 259
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-7291
Mailing Address - Country:US
Mailing Address - Phone:561-701-1328
Mailing Address - Fax:
Practice Address - Street 1:7611 S 36TH ST APT 259
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-7291
Practice Address - Country:US
Practice Address - Phone:561-701-1328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-50187103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst