Provider Demographics
NPI:1043386048
Name:MACDUFF, SUSAN FORD (MA MFT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:FORD
Last Name:MACDUFF
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BRIAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-892-4099
Mailing Address - Fax:860-889-1627
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:SUITE 317
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-892-4099
Practice Address - Fax:860-889-1627
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000594106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist