Doctor Name: | SUSAN MCMILLAN |
NPI Number: | 1063883577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.,C.C.C. |
License Number: | SA9154 |
Business Practice Address: | 1223 Lornewood Dr Valrico, FL - 335967138 |
Business Phone Number: | 8139565269 |
Business Fax Number: | |
Mailing Address: | 1223 Lornewood Dr, VALRICO |
State: | FL |
Postal Code: | 335967138 |
Phone Number: | 8139565269 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA9154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |