Provider Demographics
NPI:1891873824
Name:ISOLA, SUZANNE WYLLYS (LPC)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:WYLLYS
Last Name:ISOLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 FORTVIEW RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7672
Mailing Address - Country:US
Mailing Address - Phone:512-431-6565
Mailing Address - Fax:512-804-1770
Practice Address - Street 1:1823 FORTVIEW RD
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7672
Practice Address - Country:US
Practice Address - Phone:512-431-6565
Practice Address - Fax:512-804-1770
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16680 LPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health