Individual
SUZANNE BARIBWEGURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6605 N 19TH AVE STE C, PHOENIX, AZ 85015-1628
(520) 445-5832
Mailing address
6605 N 19TH AVE STE C, PHOENIX, AZ 85015-1628
(520) 445-5832
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92-2817467
—
AZ
Enumeration date
06/09/2023
Last updated
06/09/2023
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