Provider Demographics
NPI:1346779188
Name:SUTER, KELLY JUDITH (MSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:JUDITH
Last Name:SUTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 MIDLANTIC DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1573
Mailing Address - Country:US
Mailing Address - Phone:856-380-3317
Mailing Address - Fax:856-778-0636
Practice Address - Street 1:15000 MIDLANTIC DR STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1573
Practice Address - Country:US
Practice Address - Phone:856-380-3317
Practice Address - Fax:856-778-0636
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker