1306484902 NPI number — SUZETTE MARIE HUGUENIN PHD

Table of content: WHITNEY M HUNNIFORD LMHC (NPI 1306738638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306484902 NPI number — SUZETTE MARIE HUGUENIN PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGUENIN
Provider First Name:
SUZETTE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUGUENIN
Provider Other First Name:
SUZETTE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1306484902
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
KENNEDY KRIEGER INSTITUTE
Provider Second Line Business Mailing Address:
707 N BROADWAY RM 526
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21205-1832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-923-2782
Provider Business Mailing Address Fax Number:
443-923-2781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KENNEDY KRIEGER INSTITUTE
Provider Second Line Business Practice Location Address:
707 N BROADWAY RM 526
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21205-1832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-923-2782
Provider Business Practice Location Address Fax Number:
443-923-2781
Provider Enumeration Date:
12/13/2019

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: 207SG0202X , with the licence number:  2005072B , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207SG0203X , with the licence number: 2005072W , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 170100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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