Doctor Name: | MRS. SUSAN M PREVOST |
NPI Number: | 1376796920 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.CCC-SLP |
License Number: | 003192-1 |
Business Practice Address: | 20 Baxter Ct Mahopac, NY - 105414503 |
Business Phone Number: | 8456284945 |
Business Fax Number: | |
Mailing Address: | Po Box 305, MAHOPAC FALLS |
State: | NY |
Postal Code: | 105420305 |
Phone Number: | 8456284945 |
Fax Number: | |
NPI Enumeration Date: | 10/28/2008 |
NPI Last Update Date: | 10/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 003192-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |