Organization
SUSIC PSYCHOLOGICAL CONSULTING, PC
Active
Other names
SENIOR CARE PSYCHOLOGICAL CONSULTING
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL L. SUSIC MA (CEO/PRESIDENT)
(636) 300-9922
Entity
Organization
Contact information
Practice address
2451 EXECUTIVE DR STE 103, SAINT CHARLES, MO 63303-5606
(636) 300-9922
(636) 300-9924
Mailing address
350 TRAILHEAD WAY, DARDENNE PRAIRIE, MO 63368-7588
(636) 300-9922
(636) 300-9924
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01802
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498592518
—
MO
Enumeration date
05/04/2008
Last updated
05/04/2008
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