Provider Demographics
NPI:1164477899
Name:PARR, SUSAN JANE (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:JANE
Last Name:PARR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HABERSHAM MEDICAL CENTER
Mailing Address - Street 2:541 HISTORIC HWY #441-N
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-6025
Mailing Address - Country:US
Mailing Address - Phone:706-839-4050
Mailing Address - Fax:888-965-9908
Practice Address - Street 1:HABERSHAM MEDICAL CENTER
Practice Address - Street 2:541 HISTORIC HWY #441-N
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-6025
Practice Address - Country:US
Practice Address - Phone:706-839-4050
Practice Address - Fax:888-965-9908
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000566L231HA2400X, 231H00000X
PAF03251237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014231730002Medicaid
PA0014231730002Medicaid