Provider Demographics
NPI:1316297245
Name:VEILLEUX, SUZANNE (PHD, JD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:VEILLEUX
Suffix:
Gender:F
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BASSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4455
Mailing Address - Country:US
Mailing Address - Phone:843-368-6937
Mailing Address - Fax:843-757-7390
Practice Address - Street 1:29 PLANTATION PARK DR STE 108
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9010
Practice Address - Country:US
Practice Address - Phone:843-368-6937
Practice Address - Fax:843-815-2313
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ42309C134Medicare PIN