Healthcare Provider Details

I. General information

NPI: 1083297980
Provider Name (Legal Business Name): SUZANNE ELISE CAHN MMSC, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE BLDG B
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

519 CARLYLE LK
DECATUR GA
30033-4619
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-8570
  • Fax:
Mailing address:
  • Phone: 301-904-9324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number181
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: