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NPI Code Detail

MEDICARE: MS. SUSAN M POWERS MA,CCC,SLP

MEDICARE: MS. SUSAN M POWERS MA,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 PathologistSP-2772OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2314380051030OTHEROHCARESOURCE INS. CO.

General Provider Information

NPI Number : 1538129515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN M POWERS MA,CCC,SLP
Provider Business Mailing Address
First Line : 1357 COOK AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-2567
Country : US
Telephone Number : 216-221-7051
Fax Number :
Provider Business Practice Location Address
First Line : 1929A E ROYALTON RD
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-2809
Country : US
Telephone Number : 440-838-0990
Fax Number : 440-838-8440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 09/21/2011

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