Provider Demographics
NPI:1477641199
Name:MCCLURE, SUZANNE LORRAINE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LORRAINE
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 MONTPELIER CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4692
Mailing Address - Country:US
Mailing Address - Phone:410-751-9663
Mailing Address - Fax:410-601-6071
Practice Address - Street 1:844 WASHINGTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5740
Practice Address - Country:US
Practice Address - Phone:410-876-5600
Practice Address - Fax:410-876-1623
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist