Most Relevant Information
Provider Data
| NPI Number: | 1003073412 |
| Provider Name: | SUSAN WACHTER MA, LMHC, NCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH5412 |
Most Important Dates
| Enumeration Date: | 05/22/2008 |
| Last Updated: | 05/22/2008 |
Provider Practice Location
100 E. SYBELIA AVENUE
SUITE # 165
MAITLAND
FL
32751
Practice Location Phone/Fax
| Phone: | 4079631034 |
| Fax: |
Provider Mailing Location
100 E. SYBELIA AVENUE
SUITE # 165
MAITLAND
FL
32751
Provider Mailing Phone/Fax
| Phone: | 4079631034 |
| Fax: |