Provider Demographics
NPI:1225284144
Name:DARNELL, SUZANNE H (SLP/CCC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:H
Last Name:DARNELL
Suffix:
Gender:F
Credentials:SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1249
Mailing Address - Street 2:4405 EVANS TO LOCK ROAD
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-1249
Mailing Address - Country:US
Mailing Address - Phone:706-854-7598
Mailing Address - Fax:706-854-8136
Practice Address - Street 1:3523 CARNOUSTIE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-9051
Practice Address - Country:US
Practice Address - Phone:706-863-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA34235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist