Individual
SUZANNE CHAMPAGNE EUSEBIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
166 CENTER ST STE 100, CAPE CANAVERAL, FL 32920-3740
(860) 460-5542
Mailing address
166 CENTER ST STE 100, CAPE CANAVERAL, FL 32920-3740
(860) 460-5542
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000979
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169428221850
HUMANA
CT
01
—
410000979CT02
BLUE CROSS BLUE SHIELD
CT
01
—
574048
MOHEGAN SUN, VALUEOPTIONS
CT
Enumeration date
11/02/2006
Last updated
06/03/2022
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