Provider Demographics
NPI:1114205820
Name:PITKIN, SUZANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:PITKIN
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 1:22 CROSSHILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3721
Mailing Address - Country:US
Mailing Address - Phone:860-266-6510
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4802
Practice Address - Country:US
Practice Address - Phone:860-266-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18690235Z00000X
CT004438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist