Individual
MICHELE BECKER SUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2897 WOODLANDS PARK CT, LAKE MARY, FL 32746-1817
(407) 304-7298
Mailing address
2897 WOODLANDS PARK CT, LAKE MARY, FL 32746-1817
(407) 304-0121
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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