Provider Demographics
NPI:1073935235
Name:SAVOY, SUSAN SIOBHAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SIOBHAN
Last Name:SAVOY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:SAVOY
Other - Last Name:FOURACRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:45 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1305
Mailing Address - Country:US
Mailing Address - Phone:774-571-0337
Mailing Address - Fax:
Practice Address - Street 1:45 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1305
Practice Address - Country:US
Practice Address - Phone:774-571-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist