MEDICARE: SUSAN G HAYDEN MS, 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
1	235Z00000X	Speech-Language Pathologist	SL009974	PA

General Provider Information

NPI Number	:	1245606938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN G HAYDEN MS, CCC-SLP

Provider Business Mailing Address
First Line	:	1544 MOUNT COBB RD
Second Line	:
City	:	JEFFERSON TOWNSHIP
State	:	PA
Zip	:	18436-3233
Country	:	US
Telephone Number	:	570-955-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1544 MOUNT COBB RD
Second Line	:
City	:	JEFFERSON TOWNSHIP
State	:	PA
Zip	:	18436-3233
Country	:	US
Telephone Number	:	570-955-8655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	08/17/2015

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Directions to “ SUSAN G HAYDEN MS, CCC-SLP” Practice Location

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