Provider Demographics
NPI:1790876621
Name:CHAMBERS, SUSAN ANN (MARRIAGE AND FAMILY)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANN
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MARRIAGE AND FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5836 SO PECOS RD
Mailing Address - Street 2:# 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3418
Mailing Address - Country:US
Mailing Address - Phone:702-944-2032
Mailing Address - Fax:702-944-2033
Practice Address - Street 1:5836 SO PECOS RD
Practice Address - Street 2:# 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3418
Practice Address - Country:US
Practice Address - Phone:702-944-2032
Practice Address - Fax:702-944-2033
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist