Provider Demographics
NPI:1376718668
Name:FAUST, SUZANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:FAUST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6787 W TROPICANA AVE
Mailing Address - Street 2:SUITE 272
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4757
Mailing Address - Country:US
Mailing Address - Phone:702-362-0003
Mailing Address - Fax:702-988-5344
Practice Address - Street 1:6787 W TROPICANA AVE
Practice Address - Street 2:SUITE 272
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4757
Practice Address - Country:US
Practice Address - Phone:702-362-0003
Practice Address - Fax:702-988-5344
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist