| Doctor Name: | SUSAN VANESSEN |
| NPI Number: | 1699912980 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A.,C.C.C. |
| License Number: | 00073 |
| Business Practice Address: | 2555 Berkshire Pkwy Suite B Clive, IA - 503254646 |
| Business Phone Number: | 5159878835 |
| Business Fax Number: | 5159874637 |
| Mailing Address: | 4590 Deerwood Cir, JOHNSTON |
| State: | IA |
| Postal Code: | 501311343 |
| Phone Number: | 5152013551 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2009 |
| NPI Last Update Date: | 01/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 00073 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| 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 |