Provider Demographics
NPI:1215592068
Name:SUESS, ADRIENNE ELIZABETH (LAC, DIPLAC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ELIZABETH
Last Name:SUESS
Suffix:
Gender:F
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W 33RD ST APT 112
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3723
Mailing Address - Country:US
Mailing Address - Phone:651-485-8169
Mailing Address - Fax:
Practice Address - Street 1:123 W 33RD ST APT 112
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3723
Practice Address - Country:US
Practice Address - Phone:651-485-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1910171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty