Provider Demographics
NPI:1982633095
Name:REID, SUSANNA (ND)
Entity Type:Individual
Prefix:DR
First Name:SUSANNA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3037 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1422
Mailing Address - Country:US
Mailing Address - Phone:808-551-4161
Mailing Address - Fax:808-735-5780
Practice Address - Street 1:3037 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1422
Practice Address - Country:US
Practice Address - Phone:808-551-4161
Practice Address - Fax:808-735-5780
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR927175F00000X
HI179175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath