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Individual

DR. SUZANNE COURTNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
129 FRANKLIN PL, SOUTH BEND, IN 46601-1543
(574) 234-5606
Mailing address
707 CEDAR ST STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041640A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
20041640A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300017016
IN
Enumeration date
11/12/2008
Last updated
10/17/2018
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