Provider Demographics
NPI:1477787851
Name:CHASE, SUSAN ESPERANZA
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ESPERANZA
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:ESPERANZA
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:53 E PERIWINKLE LN
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-6216
Mailing Address - Country:US
Mailing Address - Phone:302-242-3523
Mailing Address - Fax:
Practice Address - Street 1:2801 DEVINE ST STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2511
Practice Address - Country:US
Practice Address - Phone:302-242-3523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE02-0000080231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist