Provider Demographics
NPI:1699989988
Name:APOLLON, SUSAN BARBARA (MA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:BARBARA
Last Name:APOLLON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HESTON HALL SUITE 102
Mailing Address - Street 2:1790 YARDLEY-NEWTOWN ROAD
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:215-493-8434
Mailing Address - Fax:
Practice Address - Street 1:1790 YARDLEY-NEWTOWN ROAD SUITE 102
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-493-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006054103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist