MEDICARE: MS. SUSAN KAY BARTZ 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
1	235Z00000X	Speech-Language Pathologist	SP-363	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1740315647	OTHER	WY	BUSINESS NPI

General Provider Information

NPI Number	:	1720214026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN KAY BARTZ M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 372
Second Line	:
City	:	HARVEY
State	:	ND
Zip	:	58341-0372
Country	:	US
Telephone Number	:	701-324-4192
Fax Number	:	701-324-4192

Provider Business Practice Location Address
First Line	:	817 LINCOLN AVE
Second Line	:
City	:	HARVEY
State	:	ND
Zip	:	58341-1521
Country	:	US
Telephone Number	:	701-324-4192
Fax Number	:	701-324-4192

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

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	02/23/2021

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Directions to “ MS. SUSAN KAY BARTZ M.S., CCC-SLP” Practice Location

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