Provider Demographics
NPI:1629255641
Name:FREUNDEL, SUSAN DOROTHY
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DOROTHY
Last Name:FREUNDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:DOROTHY
Other - Last Name:FREUNDEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAC, LAC (NCCAOM)
Mailing Address - Street 1:195 STOCK STREET, SUITE 112
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-637-5131
Mailing Address - Fax:
Practice Address - Street 1:195 STOCK STREET, SUITE 112
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-637-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAX000767171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist