Provider Demographics
NPI:1902270408
Name:KAPLAN, SUZANNE JENNIFER (LMT, NTP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:JENNIFER
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:LMT, NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 S EUCLID AVE
Mailing Address - Street 2:109
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864
Mailing Address - Country:US
Mailing Address - Phone:208-610-3591
Mailing Address - Fax:
Practice Address - Street 1:102 S EUCLID AVE
Practice Address - Street 2:STE 109
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-4912
Practice Address - Country:US
Practice Address - Phone:208-610-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMASG-743174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist