| Doctor Name: | MS. SUZAN L. MYHRE |
| NPI Number: | 1023259991 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSSW |
| License Number: | 2609-125 |
| Business Practice Address: | 3301 N Ballard Rd Ste C Appleton, WI - 549119002 |
| Business Phone Number: | 9202023954 |
| Business Fax Number: | 9202023964 |
| Mailing Address: | 3301 N Ballard Rd Ste C, APPLETON |
| State: | WI |
| Postal Code: | 549119002 |
| Phone Number: | 9202023954 |
| Fax Number: | 9202023964 |
| NPI Enumeration Date: | 03/23/2009 |
| NPI Last Update Date: | 12/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2609-125 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |