Provider Demographics
NPI:1326178872
Name:VANHOOSER, SUSAN MARIE
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:VANHOOSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 BRODIE LN
Mailing Address - Street 2:APT 2122
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-8093
Mailing Address - Country:US
Mailing Address - Phone:512-633-7792
Mailing Address - Fax:
Practice Address - Street 1:3724 JEFFERSON ST
Practice Address - Street 2:SUITE 316
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6225
Practice Address - Country:US
Practice Address - Phone:512-453-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist