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General NPI Number Information
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NPI Number | 1649495904
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Entity Type | Individual
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Provider Name | SUSAN FREEDLAND PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 MELROSE AVE SUITE 103
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City | GREENWICH
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State | CT
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Zip | 06830-6257
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Country | US
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Telephone | 203-869-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 3RD AVE APT 12HW
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City | NEW YORK
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State | NY
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Zip | 10128-3416
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Country | US
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Telephone | 212-876-3344
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Fax |
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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 | 00690
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License Number State | CT
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