Provider Demographics
NPI:1144343799
Name:SPENCER, SUSAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 HARKNESS WAY
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1641
Mailing Address - Country:US
Mailing Address - Phone:412-534-4003
Mailing Address - Fax:412-534-4011
Practice Address - Street 1:COMPRO
Practice Address - Street 2:711 BINGHAM ST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203
Practice Address - Country:US
Practice Address - Phone:412-995-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2008-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101848551Medicaid