| Doctor Name: | MS. SUSAN P PETTIJOHN |
| NPI Number: | 1023154473 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CCC, SLP |
| License Number: | SL005294L |
| Business Practice Address: | 5 Eves Dr Suite 160 Marlton, NJ - 080533135 |
| Business Phone Number: | 8569859257 |
| Business Fax Number: | 8569857943 |
| Mailing Address: | 5 Eves Dr, Suite 160 MARLTON |
| State: | NJ |
| Postal Code: | 080533135 |
| Phone Number: | 8569859257 |
| Fax Number: | 8569857943 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL005294L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |