Most Relevant Information
Provider Data
| NPI Number: | 1003021106 |
| Provider Name: | SUZIE DEANN BRADDOCK LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 2945 |
Most Important Dates
| Enumeration Date: | 05/11/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
3000 N MAIN ST
SUITE C
ALTUS
OK
735211348
Practice Location Phone/Fax
| Phone: | 5804719948 |
| Fax: |
Provider Mailing Location
3000 N MAIN ST
SUITE C
ALTUS
OK
735211348
Provider Mailing Phone/Fax
| Phone: | 5804719948 |
| Fax: |