Provider Demographics
NPI:1073187548
Name:PERRY, SUZANNE GAYE (MCD/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:GAYE
Last Name:PERRY
Suffix:
Gender:F
Credentials:MCD/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3695 SW 178TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-4576
Mailing Address - Country:US
Mailing Address - Phone:863-255-9325
Mailing Address - Fax:
Practice Address - Street 1:12080 SW HIGHWAY 484
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-6408
Practice Address - Country:US
Practice Address - Phone:863-255-9325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist