Provider Demographics
NPI:1922381425
Name:KEATING, SUZANNE (EDD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 E FLORIDA AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2544
Mailing Address - Country:US
Mailing Address - Phone:303-758-4556
Mailing Address - Fax:
Practice Address - Street 1:3801 E FLORIDA AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2571
Practice Address - Country:US
Practice Address - Phone:303-758-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2355103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist