Provider Demographics
NPI:1700535226
Name:AYARZA, SUZANNE (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:AYARZA
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 FOX COVE DR # A
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4993
Mailing Address - Country:US
Mailing Address - Phone:210-749-5671
Mailing Address - Fax:
Practice Address - Street 1:2677 FOX COVE DR # A
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4993
Practice Address - Country:US
Practice Address - Phone:210-749-5671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty