Provider Demographics
NPI:1366527707
Name:BUESING, SUSAN LIENEMANN (LMFT LD MEPD)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LIENEMANN
Last Name:BUESING
Suffix:
Gender:F
Credentials:LMFT LD MEPD
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:KAY
Other - Last Name:LIENEMANN BUESING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT LD
Mailing Address - Street 1:2445 DIANNA LANE
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1632
Mailing Address - Country:US
Mailing Address - Phone:651-481-8859
Mailing Address - Fax:651-481-8858
Practice Address - Street 1:521 TANGLEWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2016
Practice Address - Country:US
Practice Address - Phone:651-334-5567
Practice Address - Fax:651-481-8858
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN77106H00000X
MN1824133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist