Provider Demographics
NPI:1578388625
Name:JARRETT, SUZANNE M (PHD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:M
Last Name:JARRETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DRCHIEF
Other - Middle Name:SILENT
Other - Last Name:STORM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:8801 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2136
Mailing Address - Country:US
Mailing Address - Phone:313-939-4343
Mailing Address - Fax:
Practice Address - Street 1:8801 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2136
Practice Address - Country:US
Practice Address - Phone:313-939-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker