Individual
DR. SUSAN M FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
100 MANSFIELD AVE, BURLINGTON, VT 05401-3322
(802) 734-5876
(802) 489-5294
Mailing address
100 MANSFIELD AVE, BURLINGTON, VT 05401-3322
(802) 734-5876
(802) 489-5294
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
0480000609
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1431
—
VT
01
—
28128
BC/BS
VT
01
—
41402
MVP
VT
Enumeration date
07/14/2006
Last updated
11/20/2015
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