MEDICARE: MS. SUSAN MARIE LAHEY

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	106H00000X	Marriage & Family Therapist	634	TN

General Provider Information

NPI Number	:	1336339399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN MARIE LAHEY

Provider Business Mailing Address
First Line	:	605 HUFFINE MANOR CIR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-5671
Country	:	US
Telephone Number	:	615-491-6114
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 BILLINGSLY CT STE 3
Second Line	:	SUITE 3
City	:	FRANKLIN
State	:	TN
Zip	:	37067-6445
Country	:	US
Telephone Number	:	615-491-6114
Fax Number	:

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	05/09/2016

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