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General NPI Number Information
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NPI Number | 1447293410
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Entity Type | Individual
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Provider Name | SUSAN ROVIARO PHD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 2001 CLAFLIN RD
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City | MANHATTAN
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State | KS
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Zip | 66502-3415
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Country | US
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Telephone | 785-587-4300
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Fax | 785-587-4321
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Provider Business Mailing Address
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Address Line | 423 HOUSTON STREET PO BOX 747
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City | MANHATTAN
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State | KS
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Zip | 66505-0747
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Country | US
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Telephone | 785-587-4326
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Fax | 785-587-4377
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0584
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License Number State | KS
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