Provider Demographics
NPI:1477789857
Name:CHIZNER, SUSAN A (MS,CCC/SP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:A
Last Name:CHIZNER
Suffix:
Gender:F
Credentials:MS,CCC/SP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:A
Other - Last Name:ZAMBROFSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC/SP
Mailing Address - Street 1:620 2ND KEY DR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-3804
Mailing Address - Country:US
Mailing Address - Phone:954-522-0037
Mailing Address - Fax:954-522-0038
Practice Address - Street 1:620 2ND KEY DR
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3804
Practice Address - Country:US
Practice Address - Phone:954-522-0037
Practice Address - Fax:954-522-0038
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-30
Last Update Date:2009-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist