Provider Demographics
NPI:1023298361
Name:SUESS, CRESSIDA (PHD)
Entity type:Individual
Prefix:DR
First Name:CRESSIDA
Middle Name:
Last Name:SUESS
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 1:2905 SAN GABRIEL ST STE 215
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3541
Mailing Address - Country:US
Mailing Address - Phone:512-919-6309
Mailing Address - Fax:
Practice Address - Street 1:2905 SAN GABRIEL ST STE 215
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3541
Practice Address - Country:US
Practice Address - Phone:512-919-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist