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Mrs. Suzanne Marie Wallace, MED
Counselor in Bridgeport, Connecticut
NPI 1659433985

Suzanne Marie Wallace is a Counselor based in Fairfield, CT. Suzanne Marie Wallace practices in Bridgeport, CT and has the professional credentials of MED. The NPI Number for Suzanne Marie Wallace is 1659433985 and holds a License No. (Connecticut).

The current practice location address for Suzanne Marie Wallace is 180 Fairfield Ave, Bridgeport, CT and can be reached out via phone at 203-394-6529.

Location: 180 Fairfield Ave, Bridgeport, CT, 06824-6702
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659433985
Provider Name
Suzanne Marie Wallace
Credential
MED
Provider Entity Type
Individual
Gender
Female
Address
180 Fairfield Ave, Bridgeport, CT, 06824-6702
Phone Number
203-394-6529
Fax Number
Provider Enumeration Date
12/14/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
180 Fairfield Ave
City
Bridgeport
State
Connecticut
Zip
06604-4252
Phone Number
203-394-6529
Fax Number
person
Provider Business Mailing Address Details
Address
180 Fairfield Ave
City
Bridgeport
State
Connecticut
Zip
06604-4252
Phone Number
203-394-6529
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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