Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
N | 102L00000X | Psychologist | 19000051 | NY |
N | 103T00000X | Psychologist | 19000051 | NY |
NPI | 1003010091 |
---|---|
Provider Name | Ms. Susan P Chrystal |
First Address | Summit, NJ 07901 |
Second Address | Madison, NJ 07940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |