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NPI Code Detail

MEDICARE: SUSAN M TODD M.S., CCC-SLP

MEDICARE: SUSAN M TODD M.S., 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
1235Z00000XSpeech-Language Pathologist2088LA

General Provider Information

NPI Number : 1386086494
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M TODD M.S., CCC-SLP
Provider Business Mailing Address
First Line : 14095 SCOTT PL
Second Line :
City : HAMMOND
State : LA
Zip : 70403-7510
Country : US
Telephone Number : 985-320-2189
Fax Number :
Provider Business Practice Location Address
First Line : 132 S 6TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-3317
Country : US
Telephone Number : 985-386-6884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2013
Last Update Date : 07/18/2013

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