Provider Demographics
NPI:1982428827
Name:MATTHEWS, SUSAN DENISE
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:DENISE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8390 LYNDON B JOHNSON FWY STE 575
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1289
Mailing Address - Country:US
Mailing Address - Phone:214-918-1999
Mailing Address - Fax:
Practice Address - Street 1:8390 LYNDON B JOHNSON FWY STE 575
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1289
Practice Address - Country:US
Practice Address - Phone:214-918-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional