| Doctor Name: | MS. SUSAN ANN TANGIRES |
| NPI Number: | 1033171061 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC LCADC |
| License Number: | LCA343 |
| Business Practice Address: | 1406b Crain Hwy S Arundel Psychotherapy Assoc Suite 301 Glen Burnie, MD - 210614099 |
| Business Phone Number: | 4107605588 |
| Business Fax Number: | 4107609727 |
| Mailing Address: | 3134 Chatham Ct, ELLICOTT CITY |
| State: | MD |
| Postal Code: | 210422410 |
| Phone Number: | 4104658448 |
| Fax Number: | 4107609727 |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LCA343 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |