Provider Demographics
NPI:1659617603
Name:DAREN, SUZY FAYE NATASHA (MFT)
Entity type:Individual
Prefix:
First Name:SUZY
Middle Name:FAYE NATASHA
Last Name:DAREN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 AUDUBON PRESERVE LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5738
Mailing Address - Country:US
Mailing Address - Phone:510-406-2168
Mailing Address - Fax:
Practice Address - Street 1:2326 AUDUBON PRESERVE LN
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5738
Practice Address - Country:US
Practice Address - Phone:510-406-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000982106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist