Doctor Name: | SUSAN E RAMBO |
NPI Number: | 1114008836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 0890001005 |
Business Practice Address: | 308 Main St Stirling Square Greenport, NY - 119441418 |
Business Phone Number: | 8023452876 |
Business Fax Number: | |
Mailing Address: | 124 Front St, Apt. B GREENPORT |
State: | NY |
Postal Code: | 119441654 |
Phone Number: | 8023452876 |
Fax Number: | |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0890001005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |