Individual provider · Type 1 NPI
Jessica Brynn Suphan
Mental Health Counselor · Malone, NY
NPI number
1093387797
Active
Practice location
31 6th St
Malone, NY 12953-1246
Fax (518) 483-3383
Mailing address
102 Court St Apt 302
Plattsburgh, NY 12901-2815
Other practice locations
- 8 Tara Ln, Plattsburgh, NY 12901-7224 · (518) 324-7131
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 015323 (NY) |
Mental Health Counselor: Definition to come...
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About NPI 1093387797
Jessica Brynn Suphan's National Provider Identifier is 1093387797, issued on Jul 13, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Malone, NY. The record was last updated on Nov 15, 2024.