Provider Demographics
NPI:1336283738
Name:HAIR, SUSANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:
Last Name:HAIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9604 PRESTON VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8063
Mailing Address - Country:US
Mailing Address - Phone:214-705-6804
Mailing Address - Fax:
Practice Address - Street 1:17430 CAMPBELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5212
Practice Address - Country:US
Practice Address - Phone:972-732-9555
Practice Address - Fax:972-250-6332
Is Sole Proprietor?:No
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical