Provider Demographics
NPI:1932836723
Name:HUGGINS, SUSAN MICHELE
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MICHELE
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 W NINETEENTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4133
Mailing Address - Country:US
Mailing Address - Phone:123-140-9312
Mailing Address - Fax:
Practice Address - Street 1:237 W 19TH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4133
Practice Address - Country:US
Practice Address - Phone:231-409-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst