Provider Demographics
NPI:1871536904
Name:SCHIRO, SUSAN J (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:SCHIRO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2076 NC HWY 42 WEST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5303
Mailing Address - Country:US
Mailing Address - Phone:919-550-3323
Mailing Address - Fax:919-550-3379
Practice Address - Street 1:2076 NC HWY 42 WEST
Practice Address - Street 2:SUITE 220
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5303
Practice Address - Country:US
Practice Address - Phone:919-550-3323
Practice Address - Fax:919-550-3379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2068103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical