Provider Demographics
NPI:1265539894
Name:HILL-MANGAN, SUSANN
Entity type:Individual
Prefix:MS
First Name:SUSANN
Middle Name:
Last Name:HILL-MANGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:M
Other - Middle Name:SUSANN
Other - Last Name:HILL-MANGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:13516 S AVENUE F 1/2
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-8010
Mailing Address - Country:US
Mailing Address - Phone:928-210-8344
Mailing Address - Fax:
Practice Address - Street 1:2450 S 4TH AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8573
Practice Address - Country:US
Practice Address - Phone:928-314-9967
Practice Address - Fax:928-314-9967
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional