Provider Demographics
NPI:1043709504
Name:DARLEY, SUSAN ELLEN X (PHD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELLEN
Last Name:DARLEY
Suffix:X
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEER PATH
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-4053
Mailing Address - Country:US
Mailing Address - Phone:609-921-1825
Mailing Address - Fax:
Practice Address - Street 1:16 DEER PATH
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-4053
Practice Address - Country:US
Practice Address - Phone:609-921-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35S100130200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical