Provider Demographics
NPI:1851462501
Name:GIURLEO, SUSAN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:GIURLEO
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 1:36 LAKE WARREN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1506
Mailing Address - Country:US
Mailing Address - Phone:978-501-2833
Mailing Address - Fax:978-952-2995
Practice Address - Street 1:166 N MAIN ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-6504
Practice Address - Country:US
Practice Address - Phone:978-501-2833
Practice Address - Fax:978-952-2995
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7759103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent