Provider Demographics
NPI:1144735275
Name:VAUGHAN, SUZANNE W (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:W
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MOUNT LEBANON BLVD STE 411
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1249
Mailing Address - Country:US
Mailing Address - Phone:412-563-2434
Mailing Address - Fax:
Practice Address - Street 1:250 MOUNT LEBANON BLVD STE 411
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-1249
Practice Address - Country:US
Practice Address - Phone:412-563-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00526400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist