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Organization
SUSANNAH DEVAULT
Active
Organization
SUSANNAH DEVAULT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNAH DEVAULT LCSW (LICENSED CLINICAL SOCIAL WORKER)
(765) 532-0569
Entity
Organization
Contact information
Practice address
2639 YEAGER RD, WEST LAFAYETTE, IN 47906-1337
(765) 532-0569
(765) 497-9395
Mailing address
2639 YEAGER RD, WEST LAFAYETTE, IN 47906-1337
(765) 532-0569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005290A
IN
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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