Provider Demographics
NPI:1649769886
Name:JOSEPH, SUSAN (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14455 JAMES MADISON HWY
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-4136
Mailing Address - Country:US
Mailing Address - Phone:434-510-1000
Mailing Address - Fax:
Practice Address - Street 1:14455 JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-4136
Practice Address - Country:US
Practice Address - Phone:434-510-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0813000684103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool