Provider Demographics
NPI:1114334349
Name:METZGER, SUZI L
Entity Type:Individual
Prefix:
First Name:SUZI
Middle Name:L
Last Name:METZGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUZI
Other - Middle Name:L
Other - Last Name:DRIVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS IADC
Mailing Address - Street 1:3019 TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOCKTON
Mailing Address - State:IA
Mailing Address - Zip Code:50836-8028
Mailing Address - Country:US
Mailing Address - Phone:712-621-8553
Mailing Address - Fax:
Practice Address - Street 1:3019 TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:BLOCKTON
Practice Address - State:IA
Practice Address - Zip Code:50836-8028
Practice Address - Country:US
Practice Address - Phone:712-621-8553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)