| Doctor Name: | DR. SUSAN ELISABET ENCK |
| NPI Number: | 1003170580 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 9530 |
| Business Practice Address: | 8 Avalon Dr Apt 9 Marlborough, MA - 017523577 |
| Business Phone Number: | 6176970849 |
| Business Fax Number: | |
| Mailing Address: | 8 Avalon Dr Apt 9, MARLBOROUGH |
| State: | MA |
| Postal Code: | 017523577 |
| Phone Number: | 6176970849 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2012 |
| NPI Last Update Date: | 06/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 9530 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |