Provider Demographics
NPI:1558394635
Name:MOZLEY-HOPKINS, SUSANNAH L (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNAH
Middle Name:L
Last Name:MOZLEY-HOPKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SUSANNAH
Other - Middle Name:L
Other - Last Name:MOZLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:9 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2219
Mailing Address - Country:US
Mailing Address - Phone:401-330-7140
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-294-0451
Practice Address - Fax:401-294-0461
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00880103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical