Provider Demographics
NPI:1750630844
Name:JUEL, SUZANNE HARRIS (IBCLC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:HARRIS
Last Name:JUEL
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 SYCAMORE SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1878
Mailing Address - Country:US
Mailing Address - Phone:713-377-8738
Mailing Address - Fax:
Practice Address - Street 1:3418 SYCAMORE SHADOWS DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1878
Practice Address - Country:US
Practice Address - Phone:713-377-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IBCLC L-86703174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN