Provider Demographics
NPI:1558714279
Name:SWITZER, SUSIE
Entity type:Individual
Prefix:
First Name:SUSIE
Middle Name:
Last Name:SWITZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8049 139TH DR
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32060-8856
Mailing Address - Country:US
Mailing Address - Phone:386-205-5711
Mailing Address - Fax:
Practice Address - Street 1:8049 139TH DR
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32060-8856
Practice Address - Country:US
Practice Address - Phone:386-205-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator