Provider Demographics
NPI:1316718174
Name:TRUSLER, SUZANNE ADEL (MHC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ADEL
Last Name:TRUSLER
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MCINTOSH CT APT D
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4924
Mailing Address - Country:US
Mailing Address - Phone:360-972-0378
Mailing Address - Fax:
Practice Address - Street 1:804 N 19TH AVE STE 2A
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6929
Practice Address - Country:US
Practice Address - Phone:406-404-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-68922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health