MEDICARE: DR. JULIE SUHR PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	5308	OH

General Provider Information

NPI Number	:	1790213213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE SUHR PH.D.

Provider Business Mailing Address
First Line	:	1 OHIO UNIVERSITY DEPARTMENT OF PSYCHOLOGY, PORTER HALL
Second Line	:	ROOM 002
City	:	ATHENS
State	:	OH
Zip	:	45701-2942
Country	:	US
Telephone Number	:	740-593-0902
Fax Number	:	740-593-4790

Provider Business Practice Location Address
First Line	:	250 PORTER HALL DEPT OF
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-1368
Country	:	US
Telephone Number	:	740-593-1091
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2017
Last Update Date	:	07/21/2022

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