Individual
M. SUSAN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
3050
MA
103TC0700X
Clinical Psychologist
3050
MA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3050
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516155
—
MA
Enumeration date
06/23/2009
Last updated
06/23/2009
Update your record
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