Provider Demographics
NPI:1497943617
Name:SUASO, FAITH VALENTINA
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:VALENTINA
Last Name:SUASO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:NEELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2701 W INA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2505
Mailing Address - Country:US
Mailing Address - Phone:520-531-1040
Mailing Address - Fax:520-531-0255
Practice Address - Street 1:2701 W INA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2505
Practice Address - Country:US
Practice Address - Phone:520-531-1040
Practice Address - Fax:520-531-0255
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11744101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional