Basic Information
| Provider Information | |||||||||
| NPI: | 1710012356 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUHRE | ||||||||
| FirstName: | TERRI | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1705 MAPLE ST | ||||||||
| Address2: | ROOM B-1 | ||||||||
| City: | HOMESTEAD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151201800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124644781 | ||||||||
| FaxNumber: | 4124641531 | ||||||||
| Practice Location | |||||||||
| Address1: | 1705 MAPLE ST | ||||||||
| Address2: | ROOM B-1 | ||||||||
| City: | HOMESTEAD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151201800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124644781 | ||||||||
| FaxNumber: | 4124641531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.