Provider Demographics
NPI:1497893846
Name:WALTHER, SUSAN E (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:WALTHER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1918
Mailing Address - Country:US
Mailing Address - Phone:215-614-0936
Mailing Address - Fax:215-614-0298
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:538 MALONEY BUILDING, MEDICAL GENETICS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-614-0936
Practice Address - Fax:215-614-0298
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS