Provider Demographics
NPI:1467512061
Name:MACFARLANE, SUZANNE DUCHARME (MS CCC - SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:DUCHARME
Last Name:MACFARLANE
Suffix:
Gender:F
Credentials:MS CCC - SLP
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:DUCHARME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:273 HANOVER ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339
Mailing Address - Country:US
Mailing Address - Phone:339-214-2906
Mailing Address - Fax:877-448-2517
Practice Address - Street 1:273 HANOVER ST
Practice Address - Street 2:UNIT 1
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339
Practice Address - Country:US
Practice Address - Phone:339-214-2906
Practice Address - Fax:877-448-2517
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0039403Medicare UPIN