| Doctor Name: | MS. SUSAN WACHTER |
| NPI Number: | 1003073412 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMHC, NCC |
| License Number: | MH5412 |
| Business Practice Address: | 100 E. Sybelia Avenue Suite # 165 Maitland, FL - 32751 |
| Business Phone Number: | 4079631034 |
| Business Fax Number: | |
| Mailing Address: | 100 E. Sybelia Avenue, Suite # 165 MAITLAND |
| State: | FL |
| Postal Code: | 32751 |
| Phone Number: | 4079631034 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2008 |
| NPI Last Update Date: | 05/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH5412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |