MEDICARE: SUSAN SISK-PRICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	ATC145	MD

General Provider Information

NPI Number	:	1548632060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN SISK-PRICE

Provider Business Mailing Address
First Line	:	441 LITTLE ELK CREEK RD
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-1829
Country	:	US
Telephone Number	:	443-907-0696
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 LITTLE ELK CREEK RD
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-1829
Country	:	US
Telephone Number	:	443-907-0696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2015
Last Update Date	:	08/20/2024

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Directions to “ SUSAN SISK-PRICE ” Practice Location

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