Dragovich, Susan Lynn
Dragovich, Susan Lynn is an individual health care provider with primary practice located at 1012 Nw Wall 260 , Bend OR 97701. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Dragovich, Susan Lynn can be contacted via phone (541) 388-0180.Contact Information
Primary practice address
1012 Nw Wall 260
Bend OR 97701
Phone: (541) 388-0180
Fax: (541) 388-0180
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 389 | Oregon |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 389 | Oregon |
Profile Details
| NPI number | 1477618346 |
|---|---|
| LBN Legal business name | Dragovich, Susan Lynn |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477618346 | NPPES |
| Oregon | Other | 078535 J25302 | OR OMAP PROVIDER |
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