Provider Demographics
NPI:1902879166
Name:KAYE-HUNTINGTON, SUSAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:KAYE-HUNTINGTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 WALNUT ST
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4719
Mailing Address - Country:US
Mailing Address - Phone:215-438-4862
Mailing Address - Fax:
Practice Address - Street 1:1315 WALNUT ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4719
Practice Address - Country:US
Practice Address - Phone:215-438-4862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015287103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical