| NPI | 1871705053 |
|---|---|
| Former Name | SUSAN ANN CORRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 8296) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |