Provider Demographics
NPI:1710227889
Name:BARRON, SUZANNE MARY (MS, LMFT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARY
Last Name:BARRON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 S HIGUERA ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6987
Mailing Address - Country:US
Mailing Address - Phone:805-235-4060
Mailing Address - Fax:805-540-7063
Practice Address - Street 1:3220 S HIGUERA ST
Practice Address - Street 2:SUITE 306
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6987
Practice Address - Country:US
Practice Address - Phone:805-235-4060
Practice Address - Fax:805-540-7063
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25737106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist