Individual
SUZANNE MARIE GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9674
CO
104100000X
Social Worker
Primary
680205778
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802057778
MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
MI
01
—
9674
COLORADO REGISTRATION (DORA)
CO
Enumeration date
10/10/2008
Last updated
10/10/2008
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