Provider Demographics
NPI:1043590177
Name:MORRISON, SUSAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 TABLE MESA DR
Mailing Address - Street 2:SUITE R-315
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5866
Mailing Address - Country:US
Mailing Address - Phone:805-290-2805
Mailing Address - Fax:
Practice Address - Street 1:3605 TABLE MESA DR
Practice Address - Street 2:SUITE R-315
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5866
Practice Address - Country:US
Practice Address - Phone:805-290-2805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist