Provider Demographics
NPI:1225379746
Name:D'AMORE, SUSAN BETH (MED)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BETH
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 SWANSEA MALL DR
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4119
Mailing Address - Country:US
Mailing Address - Phone:508-324-1060
Mailing Address - Fax:
Practice Address - Street 1:463 SWANSEA MALL DR
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4119
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst