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Individual

MS. KIRSTEN HAGEDORN SUDDATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
32721 GREENS WAY, LONGNECK, DE 19966
(720) 290-3728
Mailing address
32721 GREENS WAY, LONGNECK, DE 19966
(720) 290-3728

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
992511
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
801856
MEDICARE
CO
Enumeration date
01/30/2007
Last updated
02/22/2022
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