Provider Demographics
NPI:1649365313
Name:DAUB, SUZANNE (ACSW, LSW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:DAUB
Suffix:
Gender:F
Credentials:ACSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-0628
Mailing Address - Country:US
Mailing Address - Phone:215-684-5356
Mailing Address - Fax:215-232-4093
Practice Address - Street 1:31 N NARBERTH AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2347
Practice Address - Country:US
Practice Address - Phone:215-284-5081
Practice Address - Fax:610-668-1479
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW006538L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical