Provider Demographics
NPI:1184893299
Name:MCLAUGHLIN-BELTZ, SUSAN E (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:MCLAUGHLIN-BELTZ
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 1:171 LONDONDERRY TPKE
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1977
Mailing Address - Country:US
Mailing Address - Phone:603-621-9870
Mailing Address - Fax:603-621-9875
Practice Address - Street 1:171 LONDONDERRY TPKE
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1977
Practice Address - Country:US
Practice Address - Phone:603-621-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH994103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH994OtherLICENSE