Provider Demographics
NPI:1306242698
Name:PROEBSTING, SUSAN ADAMS (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ADAMS
Last Name:PROEBSTING
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:2450 E AVENIDA DE POSADA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-3057
Mailing Address - Country:US
Mailing Address - Phone:520-262-0787
Mailing Address - Fax:520-244-1681
Practice Address - Street 1:ST. MARK'S UMC
Practice Address - Street 2:1431 W. MAGEE RD
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-2116
Practice Address - Country:US
Practice Address - Phone:520-262-0787
Practice Address - Fax:520-244-1681
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2020-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ4458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical