Provider Demographics
NPI:1215275557
Name:DIEUJUSTE-SUAREZ, NANCY (MS)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:DIEUJUSTE-SUAREZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 LITTLETON DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-7104
Mailing Address - Country:US
Mailing Address - Phone:407-529-5252
Mailing Address - Fax:
Practice Address - Street 1:363 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4589
Practice Address - Country:US
Practice Address - Phone:704-262-1320
Practice Address - Fax:704-262-1322
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health