Provider Demographics
NPI:1700075660
Name:TOMASSO, SUZANNE LYNN (MA, IMHS, ITDS)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LYNN
Last Name:TOMASSO
Suffix:
Gender:F
Credentials:MA, IMHS, ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 ROYAL TERN CIR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-8287
Mailing Address - Country:US
Mailing Address - Phone:941-739-2518
Mailing Address - Fax:
Practice Address - Street 1:6376 ROYAL TERN CIR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-8287
Practice Address - Country:US
Practice Address - Phone:941-739-2518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral