Individual
DR. SUSAN D SIROTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1075 WASHINGTON ST, WEST NEWTON, MA 02465-2185
(617) 965-1885
Mailing address
1075 WASHINGTON ST, SUITE 3, WEST NEWTON, MA 02465-2185
(617) 965-1885
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
7374
MA
103T00000X
Psychologist
7374
MA
103TA0700X
Adult Development & Aging Psychologist
7374
MA
103TC0700X
Clinical Psychologist
7374
MA
103TC2200X
Clinical Child & Adolescent Psychologist
7374
MA
103TP0814X
Psychoanalysis Psychologist
Primary
7374
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7374
PSYCHOLOGIST
MA
Enumeration date
08/19/2005
Last updated
11/01/2012
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