Mahan, Suellyn M

Mahan, Suellyn M is an sole proprietor health care provider with primary practice located at 1400 E Pugh Dr Suite 3, Terre Haute IN 47802-3942. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Mahan, Suellyn M can be contacted via phone (812) 236-9569.

Contact Information

Primary practice address
1400 E Pugh Dr Suite 3 Terre Haute IN 47802-3942
Phone: (812) 236-9569
Fax: (812) 235-2929
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041149 Indiana
Behavioral Health & Social Service Providers / School 103TS0200X 20041149 Indiana

Profile Details

NPI number 1316930357
LBN Legal business name Mahan, Suellyn M
Credentials PH.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2005
Last updated Aug 4th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316930357 NPPES
Indiana MEDICAID 200154190

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