National Provider Identifier
Susan Marie Oberdorf, CCP-SLP, LIC.
Susan Marie Oberdorf, CCP-SLP, LIC. is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Newark, NY and a listed phone number of (315) 573-6602.
Profile Overview
- NPI
- 1881215648
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- May 04, 2020
- Last Updated
- May 04, 2020
Practice Location
- 133 Elmwood
- Newark, NY 14513
Phone: (315) 573-6602
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1881215648
- Entity Type
- Individual
- Last Name
- Oberdorf
- First Name
- Susan
- Middle Name
- Marie
- Name Prefix
- Mrs.
- Credential
- CCP-SLP, LIC.
- Mailing Street Address
- 133 Elmwood
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513
- Mailing Country
- US
- Mailing Phone
- (315) 573-6602
- Practice Street Address
- 133 Elmwood
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513
- Practice Country
- US
- Practice Phone
- (315) 573-6602
- Enumeration Date
- May 04, 2020
- Last Updated
- May 04, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- May 04, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)