Provider Demographics
NPI:1619987583
Name:WECHSLER, SUSAN S (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:S
Last Name:WECHSLER
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 1:20 FARMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4829
Mailing Address - Country:US
Mailing Address - Phone:301-656-3911
Mailing Address - Fax:301-656-4164
Practice Address - Street 1:20 FARMINGTON CT
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4829
Practice Address - Country:US
Practice Address - Phone:301-656-3911
Practice Address - Fax:301-656-4164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01844103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist