Provider Demographics
NPI:1114208188
Name:PERLOW, SUSAN (SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:PERLOW
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 HARRIS HILL ROAD
Mailing Address - Street 2:HARRIS HILL ELEMENTARY SCHOOL
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-407-9175
Mailing Address - Fax:
Practice Address - Street 1:4260 HARRIS HILL RD
Practice Address - Street 2:HARRIS HILL ELEMENTARY SCHOOL
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7436
Practice Address - Country:US
Practice Address - Phone:716-407-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist