Healthcare Provider Details

I. General information

NPI: 1669633384
Provider Name (Legal Business Name): SUSAN KAY FUHR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N MARTINWOOD RD YOUR JOURNEYS 104-7
KNOXVILLE TN
37923-5137
US

IV. Provider business mailing address

141 N MARTINWOOD RD YOUR JOURNEYS 104-7
KNOXVILLE TN
37923-5137
US

V. Phone/Fax

Practice location:
  • Phone: 865-244-0888
  • Fax:
Mailing address:
  • Phone: 865-244-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2960
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number2960
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2960
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: