Provider Demographics
NPI:1730419144
Name:TOFANI, SUSAN (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:TOFANI
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 1:44 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:OLD ORCHARD BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:04064-2421
Mailing Address - Country:US
Mailing Address - Phone:207-252-3564
Mailing Address - Fax:
Practice Address - Street 1:44 UNION AVE
Practice Address - Street 2:
Practice Address - City:OLD ORCHARD BEACH
Practice Address - State:ME
Practice Address - Zip Code:04064-2421
Practice Address - Country:US
Practice Address - Phone:207-252-3564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist