Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PS006839L | PA |
N | 103TC1900X | Counseling Psychologist | PS006839L | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | B1-0000464 | DE |
NPI | 1417943648 |
---|---|
Provider Name | Dr. Susan E Schmidt |
First Address | Bryn Mawr, PA 19010-1148 |
Second Address | Bryn Mawr, PA 19010-1148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 08/07/2007 |