Provider Demographics
NPI:1760217731
Name:SCHNEIDER, SUZANNE SMITH (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:SMITH
Last Name:SCHNEIDER
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 1:2313 S LILA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5542
Mailing Address - Country:US
Mailing Address - Phone:813-943-2730
Mailing Address - Fax:
Practice Address - Street 1:2313 S LILA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5542
Practice Address - Country:US
Practice Address - Phone:813-943-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty