Provider Demographics
NPI:1992146252
Name:ALLEN, SUZANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 POST RD E
Mailing Address - Street 2:SUITE 223
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5643
Mailing Address - Country:US
Mailing Address - Phone:203-220-6394
Mailing Address - Fax:
Practice Address - Street 1:1720 POST RD E
Practice Address - Street 2:SUITE 223
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5643
Practice Address - Country:US
Practice Address - Phone:203-220-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3294103TB0200X
NY017211103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral