Provider Demographics
NPI:1801134556
Name:LAY, SUSANA (MHTCM)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:LAY
Suffix:
Gender:F
Credentials:MHTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9182 NW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7314
Mailing Address - Country:US
Mailing Address - Phone:305-562-4396
Mailing Address - Fax:
Practice Address - Street 1:9182 NW 148TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-7314
Practice Address - Country:US
Practice Address - Phone:305-562-4396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator