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Individual

SUSAN L CABOULI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
313 W LIBERTY ST STE 223, LANCASTER, PA 17603-2722
(717) 475-7263
Mailing address
313 W LIBERTY ST STE 223, LANCASTER, PA 17603-2722
(717) 475-7263

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS006748L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
105771
BLUE SHIELD
PA
Enumeration date
12/06/2005
Last updated
01/05/2018
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