Provider Demographics
NPI:1144398728
Name:GILIUS, SUSAN L (MS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:L
Last Name:GILIUS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4514
Mailing Address - Country:US
Mailing Address - Phone:717-763-8864
Mailing Address - Fax:
Practice Address - Street 1:20 ERFORD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1163
Practice Address - Country:US
Practice Address - Phone:717-730-8555
Practice Address - Fax:717-730-4566
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006908L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist