Provider Demographics
NPI:1437212362
Name:CHADWICK, SUSAN GREEN (AUD, CCCA, FAAA)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:GREEN
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:AUD, CCCA, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 CAMP ALGER AVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3608
Mailing Address - Country:US
Mailing Address - Phone:703-645-7104
Mailing Address - Fax:703-876-1811
Practice Address - Street 1:7423 CAMP ALGER AVE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3608
Practice Address - Country:US
Practice Address - Phone:703-645-7104
Practice Address - Fax:703-876-1811
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA74231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist