Provider Demographics
NPI:1275637621
Name:SAINT, SUSAN DEBORAH (MFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:DEBORAH
Last Name:SAINT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 MANHATTAN BEACH BLVD
Mailing Address - Street 2:SUITE 207 PSYCHOLOGICAL WELLNESS
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4961
Mailing Address - Country:US
Mailing Address - Phone:310-376-3388
Mailing Address - Fax:310-372-0198
Practice Address - Street 1:806 MANHATTAN BEACH BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-4961
Practice Address - Country:US
Practice Address - Phone:310-376-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18036106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist