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Mrs. Suzette Carolyn-eve Diederich, MSED,LPC
Professional Counselor in Green Bay, Wisconsin
NPI 1609972280

Suzette Carolyn-eve Diederich is a Professional Counselor based in New Franken, WI and is specialized in Professional. Suzette Carolyn-eve Diederich practices in Green Bay, WI and has the professional credentials of MSED,LPC. The NPI Number for Suzette Carolyn-eve Diederich is 1609972280 and holds a License No. 3387-125 (Wisconsin).

The current practice location address for Suzette Carolyn-eve Diederich is 123 N Oakland Ave, Green Bay, WI and can be reached out via phone at 920-770-4088 and via fax at 651-705-0026. You can also correspond with Suzette Carolyn-eve Diederich through the mailing address at 3645 WILDCAT TRL APT 3, NEW FRANKEN, WI - 54229-9207 (mailing address contact number: 920-366-8590).

Location: 123 N Oakland Ave, Green Bay, WI, 54229-9207
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Provider Profile Details
NPI Number
1609972280
Provider Name
Suzette Carolyn-eve Diederich
Credential
MSED,LPC
Provider Entity Type
Individual
Gender
Female
Address
123 N Oakland Ave, Green Bay, WI, 54229-9207
Phone Number
920-770-4088
Fax Number
651-705-0026
Provider Enumeration Date
09/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
40967700 05 WI
60291900 ID=7 01 WI EDI TRADING PARTNER NO.
3387-125 01 WI LICENSED PROFESSIONAL COU
institution
Provider Business Practice Location Address Details
Address
123 N Oakland Ave
City
State
Zip
54303-2831
Phone Number
920-770-4088
Fax Number
651-705-0026
person
Provider Business Mailing Address Details
Address
123 N Oakland Ave
City
State
Zip
54303-2831
Phone Number
920-770-4088
Fax Number
651-705-0026
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
3387-125 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
3387-125 (Wisconsin)
Definition
Definition to come...
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