| Doctor Name: | SUSANNE M. VILA |
| NPI Number: | 1659553386 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5332 |
| Business Practice Address: | 333 Foundry St New Martinsville, WV - 261551142 |
| Business Phone Number: | 3044552441 |
| Business Fax Number: | 3044553446 |
| Mailing Address: | 333 Foundry St, NEW MARTINSVILLE |
| State: | WV |
| Postal Code: | 261551142 |
| Phone Number: | 3044552441 |
| Fax Number: | 3044553446 |
| NPI Enumeration Date: | 12/05/2007 |
| NPI Last Update Date: | 12/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 5332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |