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General NPI Number Information
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NPI Number | 1427868256
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Entity Type | Organization
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Legal Business Name | SUSSEX CONSORTIUM
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 17344 SWEETBRIAR RD
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City | LEWES
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State | DE
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Zip | 19958-4021
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Country | US
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Telephone | 302-645-7210
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Fax |
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Provider Business Mailing Address
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Address Line | 17344 SWEETBRIAR RD
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City | LEWES
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State | DE
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Zip | 19958-4021
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Country | US
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Telephone | 302-645-7210
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | DIANA AIDA BLAU
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Credential | M.S., CCC-SLP
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Telephone | 908-907-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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