Samuel, Sue
Samuel, Sue is an sole proprietor health care provider with primary practice located at 13218 E Mineta Ridge Dr , Vail AZ 85641-2520. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as her primary health care specialty. Samuel, Sue can be contacted via phone (520) 762-5072.Contact Information
Primary practice address
13218 E Mineta Ridge Dr
Vail AZ 85641-2520
Phone: (520) 762-5072
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | BH-2713 | Arizona |
Profile Details
| NPI number | 1003982646 |
|---|---|
| LBN Legal business name | Samuel, Sue |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 27th, 2006 |
| Last updated | Jul 9th, 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 | 1003982646 | NPPES |
| Arizona | MEDICAID | 749286 |
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