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General NPI Number Information
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NPI Number | 1811121791
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Entity Type | Individual
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Provider Name | SUSAN B SIMERMAN L.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 992 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-1616
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Country | US
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Telephone | 203-322-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 68 ROUND HILL DR
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City | STAMFORD
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State | CT
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Zip | 06903-1516
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Country | US
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Telephone | 203-461-9796
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Fax | 203-461-8897
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001319
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License Number State | CT
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