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General NPI Number Information
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NPI Number | 1700940103
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Entity Type | Individual
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Provider Name | SUSAN AMY ENGLUND PH D
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 325 N KIRKWOOD RD SUITE 333
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City | KIRKWOOD
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State | MO
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Zip | 63122-4042
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Country | US
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Telephone | 314-966-3800
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Fax | 314-966-3800
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Provider Business Mailing Address
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Address Line | 325 N KIRKWOOD RD SUITE 333
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City | KIRKWOOD
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State | MO
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Zip | 63122-4042
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Country | US
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Telephone | 314-966-3800
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Fax | 314-966-3800
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 01897
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License Number State | MO
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