Provider Demographics
NPI:1912203852
Name:RAWSON, SUSAN KATHRYN
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KATHRYN
Last Name:RAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:KATHRYN
Other - Last Name:RAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:3508 KAYLA CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9284
Mailing Address - Country:US
Mailing Address - Phone:407-670-8150
Mailing Address - Fax:
Practice Address - Street 1:3508 KAYLA CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9284
Practice Address - Country:US
Practice Address - Phone:407-670-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health