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NPI Code Detail

MEDICARE: SUZANNE KESTERSON M.A., CCC-SLP

MEDICARE: SUZANNE KESTERSON M.A., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist11875OR

General Provider Information

NPI Number : 1063636363
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE KESTERSON M.A., CCC-SLP
Provider Business Mailing Address
First Line : 1005 SPRINGHILL DR NE
Second Line :
City : ALBANY
State : OR
Zip : 97321-1748
Country : US
Telephone Number : 541-967-4518
Fax Number : 541-924-3785
Provider Business Practice Location Address
First Line : 1005 SPRINGHILL DR NE
Second Line :
City : ALBANY
State : OR
Zip : 97321-1748
Country : US
Telephone Number : 541-967-4518
Fax Number : 541-924-3785
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 04/11/2024

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Directions to “ SUZANNE KESTERSON M.A., CCC-SLP” Practice Location

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