Susan Southerland, SLP
Individual provider Active NPI Speech-Language Pathologist · Menands, NY
NPI 1457633539 · NPPES record last updated Sep 14, 2011
Key facts
- NPI
- 1457633539
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 58 008901 (NY)
- Practice address
- 570 N Pearl St
Menands, NY 12204-1659 - Phone
- (518) 675-4800
- NPI assigned
- Sep 14, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58 008901 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 58 008901 | NY | Yes |
Addresses
Primary practice location
570 N Pearl St
Menands, NY 12204-1659
Mailing address
570 N Pearl St
Menands, NY 12204-1659
Phone (518) 675-4800
Other providers in Menands, NY
- Safecare Mobility Services, Inc.
- Dessiray Sefrin
- Ramonda Shamblee
- Paul Baxter Shorter Sr.
- Meghan Smith
- Caitlin Taylor
- Sally Dee Taylor
- Teaching to Heal Home Care LLC
- The Workshop, Inc
- The Workshop, Inc
All providers in Menands, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.