Provider Demographics
NPI:1164730420
Name:MCGURK, SUSAN R (PHD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:MCGURK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 PLEASANT ST
Mailing Address - Street 2:DARTMOUTH PSYCHIATRIC RESEARCH CENTER, MAIN BUILDING
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3852
Mailing Address - Country:US
Mailing Address - Phone:603-271-5747
Mailing Address - Fax:
Practice Address - Street 1:105 PLEASANT ST
Practice Address - Street 2:DARTMOUTH PSYCHIATRIC RESEARCH CENTER, MAIN BUILDING
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3852
Practice Address - Country:US
Practice Address - Phone:603-271-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1075103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist