MEDICARE: SUSAN KEYSER 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	SLP5603	AZ

General Provider Information

NPI Number	:	1700910254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN KEYSER SLP

Provider Business Mailing Address
First Line	:	1700 MAE AVE SW
Second Line	:	VALLE VISTA ES
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-2822
Country	:	US
Telephone Number	:	505-836-7739
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 W SHULLENBARGER DR
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86005-8960
Country	:	US
Telephone Number	:	928-255-7707
Fax Number	:

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	11/17/2025

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Directions to “ SUSAN KEYSER SLP” Practice Location

Language	Start Address	Practice Location

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