Provider Demographics
NPI:1043924301
Name:ALBAUGH, SUSAN B (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:B
Last Name:ALBAUGH
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4031
Mailing Address - Country:US
Mailing Address - Phone:202-288-4053
Mailing Address - Fax:
Practice Address - Street 1:6181 ROCKFISH GAP TPKE
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3325
Practice Address - Country:US
Practice Address - Phone:202-288-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202011157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist