Provider Demographics
NPI:1497847909
Name:POWELL, SUZANNE S (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:S
Last Name:POWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:S
Other - Last Name:RUFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:935 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1063
Mailing Address - Country:US
Mailing Address - Phone:216-291-1643
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:LOUIS B STOKES CLEVELAND VA MEDICAL CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-707-5934
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5139103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical