Provider Demographics
NPI:1730266909
Name:FAGER, SUSAN KATHERINE (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KATHERINE
Last Name:FAGER
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5401 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2150
Mailing Address - Country:US
Mailing Address - Phone:402-483-9459
Mailing Address - Fax:402-486-8381
Practice Address - Street 1:985450 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2855
Practice Address - Country:US
Practice Address - Phone:402-559-8943
Practice Address - Fax:402-559-5753
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE847235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist