Provider Demographics
NPI:1083779599
Name:DUBIN-MCNEIL, SUSAN L (EDD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:DUBIN-MCNEIL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:DUBIN-MCNEIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:WEST MARIN HEALTH AND HUMAN SERVICES
Mailing Address - City:POINT REYES STATION
Mailing Address - State:CA
Mailing Address - Zip Code:94956-0331
Mailing Address - Country:US
Mailing Address - Phone:415-663-8231
Mailing Address - Fax:415-473-3828
Practice Address - Street 1:100 6TH ST PT REYES
Practice Address - Street 2:
Practice Address - City:PT REYES
Practice Address - State:CA
Practice Address - Zip Code:94956
Practice Address - Country:US
Practice Address - Phone:415-663-8231
Practice Address - Fax:415-473-3828
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist