Provider Demographics
NPI:1982418414
Name:DOWNER, SUSANA ITZEL (CMI)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:ITZEL
Last Name:DOWNER
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:SUSANA
Other - Middle Name:ITZEL
Other - Last Name:PENA VELAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMI
Mailing Address - Street 1:17924 E IDA AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5905
Mailing Address - Country:US
Mailing Address - Phone:513-600-7353
Mailing Address - Fax:
Practice Address - Street 1:17924 E IDA AVE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5905
Practice Address - Country:US
Practice Address - Phone:513-600-7353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO015223171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter