Provider Demographics
NPI:1043515760
Name:DRAPER, SUZANNE ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ROSE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75021
Mailing Address - Country:US
Mailing Address - Phone:903-465-6344
Mailing Address - Fax:903-465-5943
Practice Address - Street 1:416 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75021-2822
Practice Address - Country:US
Practice Address - Phone:903-465-6344
Practice Address - Fax:903-465-5943
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health