Provider Demographics
NPI:1508880311
Name:PERDOS, SUSAN MARINA (RN, NCTMB, LMT, CCHT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARINA
Last Name:PERDOS
Suffix:
Gender:F
Credentials:RN, NCTMB, LMT, CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5486 WOODLAND PL
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9506
Mailing Address - Country:US
Mailing Address - Phone:330-519-4247
Mailing Address - Fax:330-533-6678
Practice Address - Street 1:5486 WOODLAND PL
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9506
Practice Address - Country:US
Practice Address - Phone:330-519-4247
Practice Address - Fax:330-533-6678
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN269374163WM1400X, 163W00000X, 175L00000X, 175F00000X
WV20032345225700000X
PA308981-00225700000X, 163WM1400X
PARN509068L175L00000X, 175F00000X, 163W00000X
WV2003-1345163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163W00000XNursing Service ProvidersRegistered Nurse
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175L00000XOther Service ProvidersHomeopath