National Provider Identifier
Susan Mack, SLP
Susan Mack, SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Penfield, NY and a listed phone number of (585) 259-0772.
Profile Overview
- NPI
- 1669616793
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- April 20, 2009
- Last Updated
- February 18, 2016
Practice Location
- 15 Dovehill Cir
- Penfield, NY 14526-1981
Phone: (585) 259-0772
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1669616793
- Entity Type
- Individual
- Last Name
- Mack
- First Name
- Susan
- Name Prefix
- MS.
- Credential
- SLP
- Provider Other Last Name
- Kwiatkowski
- Provider Other First Name
- Susan
- Provider Other Name Prefix Text
- MS.
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 15 Dovehill Cir
- Mailing City
- Penfield
- Mailing State
- NY
- Mailing ZIP Code
- 14526-1981
- Mailing Country
- US
- Mailing Phone
- (585) 259-0772
- Practice Street Address
- 15 Dovehill Cir
- Practice City
- Penfield
- Practice State
- NY
- Practice ZIP Code
- 14526-1981
- Practice Country
- US
- Practice Phone
- (585) 259-0772
- Enumeration Date
- April 20, 2009
- Last Updated
- February 18, 2016
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)