Provider Demographics
NPI:1164501854
Name:ENOCHS, SUZANNE PARK (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:PARK
Last Name:ENOCHS
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 1:1380 FRIZZELL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-6844
Mailing Address - Country:US
Mailing Address - Phone:731-234-9200
Mailing Address - Fax:
Practice Address - Street 1:524 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DECATURVILLE
Practice Address - State:TN
Practice Address - Zip Code:38329-8101
Practice Address - Country:US
Practice Address - Phone:731-852-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist