Provider Demographics
NPI:1922487008
Name:SUZANNE RABUSE AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:SUZANNE RABUSE AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RABUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-314-1890
Mailing Address - Street 1:1599 SELBY AVE
Mailing Address - Street 2:SUITE - 107LL
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6218
Mailing Address - Country:US
Mailing Address - Phone:651-314-1890
Mailing Address - Fax:
Practice Address - Street 1:1599 SELBY AVE
Practice Address - Street 2:SUITE - 107LL
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6218
Practice Address - Country:US
Practice Address - Phone:651-314-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty