Provider Demographics
NPI:1174664775
Name:LOSCALZO, SUSAN TOUMMIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:TOUMMIA
Last Name:LOSCALZO
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 1:6245 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6006
Mailing Address - Country:US
Mailing Address - Phone:727-376-1111
Mailing Address - Fax:727-376-1113
Practice Address - Street 1:935 RIVERSIDE RIDGE RD
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-8801
Practice Address - Country:US
Practice Address - Phone:727-742-4159
Practice Address - Fax:727-789-0716
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA2119OtherSTATE LICENSE NUMBER