Search › Idaho › 225C00000X
Sussannie Da Costa, M.S., CRC,PSYD (ABD)
NPI 1841776184 · on the registry since 2018 · sole proprietor
Practice
- Address
- 1525 Main Ave
Saint Maries, ID 83861 - Phone
- (208) 717-1782
Registry record
- Primary taxonomy
- 225C00000X
225C00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-07-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho