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NPI Code Detail

MEDICARE: MS. SUSAN KAY ROSS M.S., CCC-SLP

MEDICARE:  MS. SUSAN KAY ROSS  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 Pathologist22001055AIN

General Provider Information

NPI Number : 1972755213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN KAY ROSS M.S., CCC-SLP
Provider Business Mailing Address
First Line : 12475 SILVER BAY CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46236-9285
Country : US
Telephone Number : 317-847-6593
Fax Number : 317-826-1147
Provider Business Practice Location Address
First Line : 12475 SILVER BAY CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46236-9285
Country : US
Telephone Number : 317-847-6593
Fax Number : 317-826-1147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2008
Last Update Date : 12/28/2009

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

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