| Suze Harrington | |
|
1415 E 2100 S Salt Lake City UT 84105-3724 | |
| (801) 474-2100 | |
| Not Available |
| Full Name | Suze Harrington |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1415 E 2100 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Bonnie Suze Harrington (OWNER) |
| Authorized Official Contact | 8014742100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suze Harrington 1415 E 2100 S Salt Lake City UT 84105-3724 Ph: (801) 474-2100 | Suze Harrington 1415 E 2100 S Salt Lake City UT 84105-3724 Ph: (801) 474-2100 |
| NPI Number | 1316153364 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 04/14/2010 |
| Medicare PECOS PAC ID | 5799817045 |
|---|---|
| Medicare Enrollment ID | O20100721000984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316153364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 137847-3501 (Utah) | Primary |
| Provider Name | Bonnie S Harrington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699825331 PECOS PAC ID: 8224160577 Enrollment ID: I20100721001003 |
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