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Provider Information for 1902078348


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Dr. SUSAN TODD FUTERAL PHD


Other Names:  
Other Name: 
Dr. SUSAN TODD MYROWITZ

Sex: Female

NPI: 1902078348
Last Updated: 2008-03-26
Certification Date:

Details

NameValue
NPI1902078348
Enumeration Date2008-03-26
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 7511 SLADE AVE
BALTIMORE, MD 21208-4537
United States

Phone: 410-580-1136 | Fax:410-580-1138
 
Primary Practice Address 7511 SLADE AVE
BALTIMORE, MD 21208-4537
United States

Phone: 410-580-1136 | Fax:410-580-1138
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)MD04787
Yes 1041C0700X - Social Worker - ClinicalMD04787
No 106H00000X - Marriage & Family Therapist MD04787