Individual
MS. SUZYN MARY DOUGLASS-EVERHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
495 ERLANGER RD, SUITE 204, ERLANGER, KY 41018-1468
(859) 342-6444
(859) 342-0999
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
172576
KY
101YP2500X
Professional Counselor
64067
TX
101YP2500X
Professional Counselor
KY-0854
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982762357
NPI
KY
Enumeration date
12/05/2006
Last updated
09/30/2019
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