Provider Demographics
NPI:1699072348
Name:PARRY, SUZANNE SWINEHART (BA,RAS)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:SWINEHART
Last Name:PARRY
Suffix:
Gender:F
Credentials:BA,RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 PRESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-4453
Mailing Address - Country:US
Mailing Address - Phone:951-236-2558
Mailing Address - Fax:951-955-6980
Practice Address - Street 1:3525 PRESLEY AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-4453
Practice Address - Country:US
Practice Address - Phone:951-236-2558
Practice Address - Fax:951-955-6980
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP0812151530101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)