Provider Demographics
NPI:1235573304
Name:MOLERA, SUZANNE RENEE (BA COMM DISORDERS)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:RENEE
Last Name:MOLERA
Suffix:
Gender:F
Credentials:BA COMM DISORDERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24602 VIA VALLARTA
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887
Mailing Address - Country:US
Mailing Address - Phone:714-692-9563
Mailing Address - Fax:
Practice Address - Street 1:160 OLD SPRINGS RD., STE. 100
Practice Address - Street 2:ANAHEIM HILLS SPEECH AND LANGUAGE CENTER
Practice Address - City:ANAHEIM HILLS
Practice Address - State:CA
Practice Address - Zip Code:92808
Practice Address - Country:US
Practice Address - Phone:714-282-8852
Practice Address - Fax:714-282-8876
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 1702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant