Individual
SUSETTE MARIE ELIZABETH GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
531 BRYDEN AVE, LEWISTON, ID 83501-4438
(208) 503-5061
Mailing address
3725 11TH ST, LEWISTON, ID 83501-5456
(208) 503-5061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9671888
ID
Other
Enumeration date
11/27/2025
Last updated
11/27/2025
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