Provider Demographics
NPI:1588156624
Name:STRATTON, SUSAN JANE
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JANE
Last Name:STRATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W MEM DR
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-2475
Mailing Address - Country:US
Mailing Address - Phone:906-482-9404
Mailing Address - Fax:
Practice Address - Street 1:901 W MEM DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-2475
Practice Address - Country:US
Practice Address - Phone:906-482-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801102688104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker