Healthcare Provider Details

I. General information

NPI: 1023971850
Provider Name (Legal Business Name): STORMIE SUHRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24230 US HIGHWAY 331
OPP AL
36467-5815
US

IV. Provider business mailing address

24230 US HIGHWAY 331
OPP AL
36467-5815
US

V. Phone/Fax

Practice location:
  • Phone: 334-493-5712
  • Fax:
Mailing address:
  • Phone: 276-970-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: