Provider Demographics
NPI:1972948180
Name:SCHUETZ, SUZAN R (PHD)
Entity Type:Individual
Prefix:
First Name:SUZAN
Middle Name:R
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S CONNOR ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-1558
Mailing Address - Country:US
Mailing Address - Phone:816-565-0500
Mailing Address - Fax:
Practice Address - Street 1:401 S CONNOR ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-1558
Practice Address - Country:US
Practice Address - Phone:816-565-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010036621103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling