Provider Demographics
NPI:1629780754
Name:LOBEL, SUZANNA
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:LOBEL
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 1:4161 BURNS RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34602-8191
Mailing Address - Country:US
Mailing Address - Phone:760-270-8006
Mailing Address - Fax:
Practice Address - Street 1:11245 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-4651
Practice Address - Country:US
Practice Address - Phone:760-270-8006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician