Provider Demographics
NPI:1548088586
Name:ORT-ULM, SUSAN THATCHER (MS, EDS)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:THATCHER
Last Name:ORT-ULM
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 NEW SCHOOL RD NW
Mailing Address - Street 2:
Mailing Address - City:MOUNT SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:21545-1050
Mailing Address - Country:US
Mailing Address - Phone:301-264-3220
Mailing Address - Fax:
Practice Address - Street 1:13201 NEW SCHOOL RD NW
Practice Address - Street 2:
Practice Address - City:MOUNT SAVAGE
Practice Address - State:MD
Practice Address - Zip Code:21545-1050
Practice Address - Country:US
Practice Address - Phone:301-264-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool