| Susannah Devault | |
|
2639 Yeager Rd West Lafayette IN 47906-1337 | |
| (765) 532-0569 | |
| (765) 497-9395 |
| Full Name | Susannah Devault |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2639 Yeager Rd, West Lafayette, Indiana |
| Authorized Official Name and Position | Susannah Devault (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7655320569 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susannah Devault 2639 Yeager Rd West Lafayette IN 47906-1337 Ph: (765) 532-0569 | Susannah Devault 2639 Yeager Rd West Lafayette IN 47906-1337 Ph: (765) 532-0569 |
| NPI Number | 1134372741 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 10/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134372741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34005290A (Indiana) | Primary |
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