Provider Demographics
NPI:1750831434
Name:MUSZYNSKI, SUSAN YULISH (PH D)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:YULISH
Last Name:MUSZYNSKI
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5053 BRISTOL CT
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2533
Mailing Address - Country:US
Mailing Address - Phone:216-702-6483
Mailing Address - Fax:440-684-1934
Practice Address - Street 1:5053 BRISTOL CT
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2533
Practice Address - Country:US
Practice Address - Phone:216-702-6483
Practice Address - Fax:440-684-1934
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical