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General NPI Number Information
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NPI Number | 1750448213
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Entity Type | Individual
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Provider Name | SUSAN J FAHLUND PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 281 PLEASANT ST
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City | FRAMINGHAM
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State | MA
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Zip | 01701-4778
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Country | US
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Telephone | 508-872-4051
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Fax |
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Provider Business Mailing Address
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Address Line | 43 WHISPERING BROOK RD
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City | MARLBOROUGH
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State | MA
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Zip | 01752-6079
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Country | US
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Telephone | 508-875-1386
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 4074
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 4074
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4074
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4074
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 4074
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License Number State | MA
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4074
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License Number State | MA
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