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General NPI Number Information
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NPI Number | 1720448301
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Entity Type | Individual
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Provider Name | SUSAN MALIA ASHMEAD
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Gender | Female
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 101 WILSON DR
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City | LINCOLN UNIVERSITY
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State | PA
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Zip | 19352-9744
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Country | US
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Telephone | 484-643-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 101 WILSON DR
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City | LINCOLN UNIVERSITY
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State | PA
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Zip | 19352-9744
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Country | US
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Telephone | 484-643-0459
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC008687
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC0000736
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License Number State | DE
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