Provider Demographics
NPI:1225681943
Name:PRICE, SUZANNE (MED, LPC, FT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:MED, LPC, FT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4416 N WESTERN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-5256
Mailing Address - Country:US
Mailing Address - Phone:405-673-7951
Mailing Address - Fax:
Practice Address - Street 1:4416 N WESTERN AVE STE 207
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-5256
Practice Address - Country:US
Practice Address - Phone:405-673-7951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty