Provider Demographics
NPI:1467674598
Name:KLUGE, SUSAN ARTHUR (MFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ARTHUR
Last Name:KLUGE
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 1:1162 NORUMBEGA DR
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-1831
Mailing Address - Country:US
Mailing Address - Phone:626-355-8480
Mailing Address - Fax:626-303-1787
Practice Address - Street 1:73 W. SIERRA MADRE BL.
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024
Practice Address - Country:US
Practice Address - Phone:626-355-8480
Practice Address - Fax:626-303-1787
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21566106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist