Provider Demographics
NPI:1730292780
Name:BROOKS, SUZANNE MOYER (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MOYER
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-3833
Mailing Address - Country:US
Mailing Address - Phone:802-295-9363
Mailing Address - Fax:802-296-6389
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-3833
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:802-296-6389
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00091622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry