Provider Demographics
NPI:1922102334
Name:BRENT, SUZANNE S (PHD LMFT LCDC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:S
Last Name:BRENT
Suffix:
Gender:F
Credentials:PHD LMFT LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15185
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-5185
Mailing Address - Country:US
Mailing Address - Phone:806-457-9200
Mailing Address - Fax:806-353-4958
Practice Address - Street 1:1616 S KENTUCKY
Practice Address - Street 2:C-200
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102
Practice Address - Country:US
Practice Address - Phone:806-457-9200
Practice Address - Fax:806-353-4958
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674103TA0400X
TX3676103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily