Provider Demographics
NPI:1003253535
Name:SCRIVENER, SUZANNA LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:LYNN
Last Name:SCRIVENER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3173 TRISTAN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6243
Mailing Address - Country:US
Mailing Address - Phone:615-491-5910
Mailing Address - Fax:
Practice Address - Street 1:1647 MALLORY LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2909
Practice Address - Country:US
Practice Address - Phone:615-661-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2783235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist