| Doctor Name: | MS. SUSAN A. BORITZ |
| NPI Number: | 1639328974 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 001240 |
| Business Practice Address: | 111 Church Hill Rd Suite 305 Sandy Hook, CT - 064821172 |
| Business Phone Number: | 2039178585 |
| Business Fax Number: | 2038262211 |
| Mailing Address: | 30 Still Hill Rd, SANDY HOOK |
| State: | CT |
| Postal Code: | 064821313 |
| Phone Number: | 2032707936 |
| Fax Number: | 2038262211 |
| NPI Enumeration Date: | 09/11/2008 |
| NPI Last Update Date: | 05/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001240 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |