Active NPI
Suzanne Lynn Glenn, M.S. CCC-SLP
- Speech-Language Pathologist
- Davie, FL
National Provider Identifier
1659530301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ 4422
- Practice address
- 4851 Grapevine Way
Davie, FL 33331-3363 - Phone
- (954) 826-8565
- NPI assigned
- Jun 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ 4422 | FL | Primary |
| Developmental Therapist | 222Q00000X | SA 9942 | FL |
Addresses
Primary practice location
4851 Grapevine Way
Davie, FL 33331-3363
Mailing address
4851 Grapevine Way
Davie, FL 33331-3363
Phone (954) 826-8565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 9942 | FL | MD | Developmental Therapist |
| SZ 4422 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1659530301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4851 GRAPEVINE WAY",
"city": "DAVIE",
"state": "FL",
"postal_code": "333313363",
"telephone_number": "954-826-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4851 GRAPEVINE WAY",
"city": "DAVIE",
"state": "FL",
"postal_code": "333313363",
"telephone_number": "954-826-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "SUZANNE",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-07",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ 4422",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "SA 9942",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.