Provider Demographics
NPI:1427248160
Name:MUSSO, SUSAN ANNE (MS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANNE
Last Name:MUSSO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HORNADY DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13209-9660
Mailing Address - Country:US
Mailing Address - Phone:315-246-3070
Mailing Address - Fax:
Practice Address - Street 1:5 W CAYUGA ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2031
Practice Address - Country:US
Practice Address - Phone:315-342-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor