Basic Information
Provider Information
NPI: 1881961480
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBINGER
FirstName: SUZANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18328 FLORAL ST
Address2:  
City: LIVONIA
State: MI
PostalCode: 481523718
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2387 E WALTON BLVD
Address2:  
City: AUBURN HILLS
State: MI
PostalCode: 483261955
CountryCode: US
TelephoneNumber: 2483578197
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/27/2011
LastUpdateDate: 11/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X6801085819MIY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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