Provider Demographics
NPI:1396860383
Name:ANDREWS, SUSAN ANN (MA LLP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MA LLP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LLP
Mailing Address - Street 1:837 SEMINOLE ROAD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441
Mailing Address - Country:US
Mailing Address - Phone:231-780-0100
Mailing Address - Fax:231-780-0111
Practice Address - Street 1:837 SEMINOLE ROAD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441
Practice Address - Country:US
Practice Address - Phone:231-780-0100
Practice Address - Fax:231-780-0111
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008380103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling