Provider Demographics
NPI:1952519597
Name:CAREY, SUE RIDDLE (MS)
Entity type:Individual
Prefix:MRS
First Name:SUE
Middle Name:RIDDLE
Last Name:CAREY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 N IROQUOIS LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2925
Mailing Address - Country:US
Mailing Address - Phone:610-469-1084
Mailing Address - Fax:610-469-1083
Practice Address - Street 1:105 SIBLEY AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2311
Practice Address - Country:US
Practice Address - Phone:610-896-8379
Practice Address - Fax:610-896-7901
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006750-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist