Provider Demographics
NPI:1215193420
Name:DRUST, SUSAN MARIE (MS, CCC/SLP, TSHH,)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:DRUST
Suffix:
Gender:F
Credentials:MS, CCC/SLP, TSHH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 OLMSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2441
Mailing Address - Country:US
Mailing Address - Phone:716-684-9545
Mailing Address - Fax:716-835-2468
Practice Address - Street 1:1360 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3354
Practice Address - Country:US
Practice Address - Phone:716-835-0417
Practice Address - Fax:716-835-2648
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011810235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist