Provider Demographics
NPI:1245210475
Name:GUERZON, SUZANNE MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:GUERZON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12840 BRIGHTON DAM RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1412
Mailing Address - Country:US
Mailing Address - Phone:301-854-2889
Mailing Address - Fax:443-276-0922
Practice Address - Street 1:12840 BRIGHTON DAM RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1412
Practice Address - Country:US
Practice Address - Phone:301-854-2889
Practice Address - Fax:443-276-0922
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical