Provider Information for 1811495096
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SUZANNE BRABANT LCSW
Sex: Female
NPI: 1811495096
Last Updated: 2018-01-23
Certification Date:
Certification Date:
Details
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NPI | 1811495096 | ||||||||
Enumeration Date | 2018-01-23 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 8179 WESTMONT TERRACE DR LAKELAND, FL 33810-2083 United States Phone: | Fax: | ||||||||
Primary Practice Address | 8179 WESTMONT TERRACE DRIVE LAKELAND, FL 33810 United States Phone: 863-221-6400 | Fax: | ||||||||
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