Provider Demographics
NPI:1851660930
Name:MOHR, SUZANNE LYNNE (MSW)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LYNNE
Last Name:MOHR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 COVINGTON CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4941
Mailing Address - Country:US
Mailing Address - Phone:517-371-4971
Mailing Address - Fax:517-371-4475
Practice Address - Street 1:2929 COVINGTON CT
Practice Address - Street 2:SUITE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4941
Practice Address - Country:US
Practice Address - Phone:517-371-4971
Practice Address - Fax:517-371-4475
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801093586101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor