Provider Demographics
NPI:1245571645
Name:GRAUN, SUZANNE MICHELLE (MED)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:GRAUN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MICHELLE
Other - Last Name:FUCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9261 N MOON VIEW PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-1112
Mailing Address - Country:US
Mailing Address - Phone:520-975-1995
Mailing Address - Fax:
Practice Address - Street 1:9261 N MOON VIEW PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-1112
Practice Address - Country:US
Practice Address - Phone:520-975-1995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-09
Last Update Date:2013-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 0303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional