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General NPI Number Information
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NPI Number | 1801094727
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Entity Type | Individual
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Provider Name | SUSAN PATRICIA VINING MS CCC A
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 HEALTH CENTER BUILDING BOWLING GREEN STATE UNIVERSITY
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City | BOWLING GREEN
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State | OH
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Zip | 43403-0149
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Country | US
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Telephone | 419-372-2515
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Fax | 419-372-8089
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Provider Business Mailing Address
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Address Line | 2323 GODDARD RD
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City | TOLEDO
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State | OH
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Zip | 43606-3237
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Country | US
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Telephone | 419-578-0657
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A 0860
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License Number State | OH
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