National Provider Identifier

Susan Lynn Wiser, PH.D.

Susan Lynn Wiser, PH.D. is listed in the NPPES registry with a primary specialty of Psychologist in Ithaca, NY and a listed phone number of (607) 279-3916.

NPI 1376604512Ithaca, NYPsychologist

Profile Overview

NPI
1376604512
Provider Type
Individual
Primary Specialty
Psychologist
Enumeration Date
December 12, 2006
Last Updated
May 06, 2024

Practice Location

  • 121 W Court St
  • Ithaca, NY 14850-4105

Phone: (607) 279-3916

Mailing Address

  • 301 Assembly Dr Unit 596
  • Montreat, NC 28757-8031

Specialties

  • Psychologist (103T00000X)
  • Clinical Psychologist (103TC0700X)
Full Record
NPI
1376604512
Entity Type
Individual
Last Name
Wiser
First Name
Susan
Middle Name
Lynn
Name Prefix
Dr.
Credential
PH.D.
Mailing Street Address
301 Assembly Dr Unit 596
Mailing City
Montreat
Mailing State
NC
Mailing ZIP Code
28757-8031
Mailing Country
US
Mailing Phone
(607) 279-3916
Practice Street Address
121 W Court St
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-4105
Practice Country
US
Practice Phone
(607) 279-3916
Enumeration Date
December 12, 2006
Last Updated
May 06, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
May 06, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Psychologist (103T00000X), Clinical Psychologist (103TC0700X)