Provider Demographics
NPI:1578642351
Name:COLCHER, SUSAN D (PHD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:COLCHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 POND AVE
Mailing Address - Street 2:#611
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7129
Mailing Address - Country:US
Mailing Address - Phone:617-738-4428
Mailing Address - Fax:781-792-0688
Practice Address - Street 1:135 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1200
Practice Address - Country:US
Practice Address - Phone:781-982-9790
Practice Address - Fax:781-792-0688
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3616103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist