Basic Information
| Provider Information | |||||||||
| NPI: | 1356459176 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SKRABO | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | LINDA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 138 NEW MOHAWK RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | NEVADA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959593248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304780900 | ||||||||
| FaxNumber: | 5304780982 | ||||||||
| Practice Location | |||||||||
| Address1: | 138 NEW MOHAWK RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | NEVADA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959593248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304780900 | ||||||||
| FaxNumber: | 5304780982 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 08/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 39899 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.