Provider Demographics
NPI:1881391605
Name:HUTCHINS, SUZANNAH LEE (LAPC)
Entity type:Individual
Prefix:
First Name:SUZANNAH
Middle Name:LEE
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MOUNTAIN BROOK DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9078
Mailing Address - Country:US
Mailing Address - Phone:540-977-2863
Mailing Address - Fax:
Practice Address - Street 1:103 MOUNTAIN BROOK DR STE 103
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-9078
Practice Address - Country:US
Practice Address - Phone:540-977-2863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC007653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional