Provider Demographics
NPI:1477726065
Name:VALENTI, SUSAN C (AUD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:VALENTI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6303
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:325 MEDICAL PKWY STE 250
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2460
Practice Address - Country:US
Practice Address - Phone:864-797-9080
Practice Address - Fax:864-797-9085
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC808231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00801261OtherRR MEDICARE
SCSA1047Medicaid
SCQ348867951Medicare PIN
SCSA1047Medicaid
SCQ348863640Medicare PIN