| Doctor Name: | DR. SUSAN MATOUR |
| NPI Number: | 1194903666 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PS017084 |
| Business Practice Address: | 1503 Lansdowne Ave 3008 Darby, PA - 190231330 |
| Business Phone Number: | 6102374554 |
| Business Fax Number: | 6102372627 |
| Mailing Address: | 210 Locust St, Apt 15b PHILADELPHIA |
| State: | PA |
| Postal Code: | 191063934 |
| Phone Number: | 2159282019 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2008 |
| NPI Last Update Date: | 10/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS017084 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |