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NPI Code Detail

MEDICARE: SUSAN O'SHEA M.S.SLPCCC

MEDICARE: SUSAN O'SHEA M.S.SLPCCC
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 PathologistSL001170LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1101802OTHERPAFACILITY LICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013325869
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN O'SHEA M.S.SLPCCC
Provider Business Mailing Address
First Line : 1404 GOLF PARK DR
Second Line :
City : LAKE ARIEL
State : PA
Zip : 18436-4252
Country : US
Telephone Number : 570-698-5647
Fax Number : 570-698-7742
Provider Business Practice Location Address
First Line : 1404 GOLF PARK DR
Second Line :
City : LAKE ARIEL
State : PA
Zip : 18436-4252
Country : US
Telephone Number : 570-698-5647
Fax Number : 570-698-7742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2014
Last Update Date : 07/24/2014

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Directions to “ SUSAN O'SHEA M.S.SLPCCC” Practice Location

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