Susan Carney

Individual provider Active NPI Speech-Language Pathologist · Poland, OH

NPI 1902221963 · NPPES record last updated Feb 27, 2014

Key facts

NPI
1902221963
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP7034 (OH)
Practice address
3156 Chardonnay LN
Poland, OH 44514-5822
Phone
(330) 540-3156
NPI assigned
Feb 27, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP7034OHMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP7034 OH Yes

Addresses

Primary practice location

3156 Chardonnay LN
Poland, OH 44514-5822

Mailing address

3156 Chardonnay LN
Poland, OH 44514-5822
Phone (330) 540-3156

Other identifiers

IdentifierTypeStateIssuer
SP7034MedicaidOH

Other providers in Poland, OH

All providers in Poland, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.