Healthcare Provider Details

I. General information

NPI: 1508880311
Provider Name (Legal Business Name): SUSAN MARINA PERDOS RN, NCTMB, LMT, CCHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5486 WOODLAND PL
CANFIELD OH
44406-9506
US

IV. Provider business mailing address

5486 WOODLAND PL
CANFIELD OH
44406-9506
US

V. Phone/Fax

Practice location:
  • Phone: 330-519-4247
  • Fax: 330-533-6678
Mailing address:
  • Phone: 330-519-4247
  • Fax: 330-533-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License NumberRN269374
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN269374
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number20032345
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number308981-00
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberRN269374
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberRN509068L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberRN509068L
License Number StatePA
# 8
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberRN269374
License Number StateOH
# 9
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number308981-00
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN509068L
License Number StatePA
# 11
Primary TaxonomyN
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number2003-1345
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: