Provider Demographics
NPI:1467843797
Name:REES, SUSAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:REES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ATWOOD DR
Mailing Address - Street 2:CLINICAL & SUPPORT OPTIONS SUITE 301
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4272
Mailing Address - Country:US
Mailing Address - Phone:413-584-8084
Mailing Address - Fax:
Practice Address - Street 1:8 ATWOOD DR
Practice Address - Street 2:CLINICAL & SUPPORT OPTIONS SUITE 301
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4272
Practice Address - Country:US
Practice Address - Phone:413-584-8084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN257490364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult