Provider Demographics
NPI:1588995476
Name:FOTI, R SUSAN (MED, LMFT)
Entity type:Individual
Prefix:MRS
First Name:R
Middle Name:SUSAN
Last Name:FOTI
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8414
Mailing Address - Country:US
Mailing Address - Phone:561-241-9741
Mailing Address - Fax:
Practice Address - Street 1:2480 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8414
Practice Address - Country:US
Practice Address - Phone:561-241-9741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT949106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist