DR. Susanna Angelica Lack, PSY.D.
NPI #1255311718 in Media, Pennsylvania
Provider Information
- NPI Number
- 1255311718
- Entity Type
- Individual
- Name
- DR. Susanna Angelica Lack, PSY.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Credential
- PSY.D.
- Enumeration Date
- Jan 20, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 211 N MONROE ST
- Address 2
- 2ND FLOOR
- City
- Media
- State
- Pennsylvania
- ZIP Code
- 19063-3019
- Phone
- (610) 891-9923
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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