Provider Demographics
NPI:1497893846
Name:WALTHER, SUSAN E (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:WALTHER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 500
Practice Address - Street 2:
Practice Address - City:INTERCOURSE
Practice Address - State:PA
Practice Address - Zip Code:17534-0500
Practice Address - Country:US
Practice Address - Phone:717-687-9407
Practice Address - Fax:717-687-9237
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000134170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS