Doctor Name: | MRS. SUSAN L MACIOS |
NPI Number: | 1154454478 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | |
Business Practice Address: | 112 N Broad St 8th Fl Philadelphia, PA - 191021510 |
Business Phone Number: | 2155680860 |
Business Fax Number: | 2155680769 |
Mailing Address: | 1 Cherry Cir, BLACKWOOD |
State: | NJ |
Postal Code: | 080124670 |
Phone Number: | 8563749613 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |