| Doctor Name: | SUSAN MARIE DILSWORTH |
| NPI Number: | 1063719037 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 6301013131 |
| Business Practice Address: | 6189 Lake Michigan Dr Allendale, MI - 494019244 |
| Business Phone Number: | 8779324446 |
| Business Fax Number: | 6165886046 |
| Mailing Address: | 12250 Knoper Ct, ALLENDALE |
| State: | MI |
| Postal Code: | 494018046 |
| Phone Number: | 8779324446 |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2011 |
| NPI Last Update Date: | 04/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301013131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |