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General NPI Number Information
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NPI Number | 1245634617
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Entity Type | Individual
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Provider Name | MRS. SUSAN LYNN WOOLF
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Gender | Female
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 5279 EDUCATION DR
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City | GREENVILLE
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State | OH
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Zip | 45331-9759
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Country | US
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Telephone | 937-548-4915
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Fax |
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Provider Business Mailing Address
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Address Line | 7795 ZERBER RD
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City | BRADFORD
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State | OH
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Zip | 45308-9613
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Country | US
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Telephone | 937-448-9133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP6782
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License Number State | OH
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