Provider Demographics
NPI:1790152452
Name:LARABELL, SUSAN KELLY (MS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KELLY
Last Name:LARABELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE
Mailing Address - Street 2:BOX 120
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-4123
Mailing Address - Fax:720-777-7118
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:BOX 120
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-4123
Practice Address - Fax:720-777-7118
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS