1780819334 NPI number — SUZANNE NICOLE WARD BCBA

Table of content: SUZANNE NICOLE WARD BCBA (NPI 1780819334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780819334 NPI number — SUZANNE NICOLE WARD BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARD
Provider First Name:
SUZANNE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAYLOR
Provider Other First Name:
SUZANNE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BCBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780819334
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MARKTSTRASSE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAMSTEIN
Provider Business Mailing Address State Name:
RHINELAND- PFALZ
Provider Business Mailing Address Postal Code:
66877
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
4915175189573
Provider Business Mailing Address Fax Number:
49163715946037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MARKTSTRASSE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAMSTEIN
Provider Business Practice Location Address State Name:
RHINELAND-PFALZ
Provider Business Practice Location Address Postal Code:
66877
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
15175189573
Provider Business Practice Location Address Fax Number:
063715946037
Provider Enumeration Date:
05/27/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)