Provider Demographics
NPI:1477981223
Name:KNIER, SUSAN MARY (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:KNIER
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S84W17737 ORCHARD CT
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8797
Mailing Address - Country:US
Mailing Address - Phone:414-810-7381
Mailing Address - Fax:
Practice Address - Street 1:S84W17737 ORCHARD CT
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-8797
Practice Address - Country:US
Practice Address - Phone:414-810-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI106-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist