Organization
SHADYBROOK PSYCHOLOGICAL SERVICES PLLC
Active
Organization
SHADYBROOK PSYCHOLOGICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSANNE PALMER PHD (OWNER/AUTHORIZED OFFICIAL)
(336) 200-8808
Entity
Organization
Contact information
Practice address
2554 LEWISVILLE CLEMMONS RD STE 304, CLEMMONS, NC 27012-8749
(636) 487-7654
Mailing address
2554 LEWISVILLE CLEMMONS RD STE 304, CLEMMONS, NC 27012-8749
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
06/17/2024
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