Individual
SUZANNE B WING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
117 W MAIN ST STE 109, LANCASTER, OH 43130-3799
(740) 689-9609
(740) 687-2725
Mailing address
283 LAKEVIEW DR NE, LANCASTER, OH 43130-8869
(740) 689-9609
(740) 687-2725
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
5439
OH
103TA0400X
Addiction (Substance Use Disorder) Psychologist
933626
OH
103TC0700X
Clinical Psychologist
Primary
5439
OH
103TP2701X
Group Psychotherapy Psychologist
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262480473027
CARESOURCE
OH
Enumeration date
07/05/2006
Last updated
05/12/2010
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