Provider Demographics
NPI:1992842587
Name:SMITH, SUSAN ALDRICH (CPM)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ALDRICH
Last Name:SMITH
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 IRONSTONE RD
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-2217
Mailing Address - Country:US
Mailing Address - Phone:508-278-2989
Mailing Address - Fax:866-433-9784
Practice Address - Street 1:48 IRONSTONE RD
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-2217
Practice Address - Country:US
Practice Address - Phone:508-278-2989
Practice Address - Fax:866-433-9784
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
96100010176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife