National Provider Identifier

Susan Jackson, SLP

Susan Jackson, SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Springville, NY and a listed phone number of (716) 592-9331.

NPI 1336717982Springville, NYSpeech-Language Pathologist

Profile Overview

NPI
1336717982
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
June 10, 2021
Last Updated
June 10, 2021

Practice Location

  • 393 North St
  • Springville, NY 14141-9652

Phone: (716) 592-9331

Mailing Address

  • 5327 Depot St
  • West Valley, NY 14171-9618

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1336717982
Entity Type
Individual
Last Name
Jackson
First Name
Susan
Credential
SLP
Mailing Street Address
5327 Depot St
Mailing City
West Valley
Mailing State
NY
Mailing ZIP Code
14171-9618
Mailing Country
US
Mailing Phone
(716) 566-8608
Practice Street Address
393 North St
Practice City
Springville
Practice State
NY
Practice ZIP Code
14141-9652
Practice Country
US
Practice Phone
(716) 592-9331
Practice Fax
(716) 592-4683
Enumeration Date
June 10, 2021
Last Updated
June 10, 2021
Sex
Female
Sole Proprietor
No
Certification Date
June 10, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)