Doctor Name: | SUSAN P GRUN |
NPI Number: | 1114989944 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | PS008061L |
Business Practice Address: | 220 Commerce Dr Suite 401 Fort Washington, PA - 190342402 |
Business Phone Number: | 2155405860 |
Business Fax Number: | 2155405864 |
Mailing Address: | 220 Commerce Dr, Suite 401 FORT WASHINGTON |
State: | PA |
Postal Code: | 190342402 |
Phone Number: | 2155405860 |
Fax Number: | 2155405864 |
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: | 103TC1900X |
License Number: | PS008061L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |