Provider Demographics
NPI:1508067695
Name:BROWN, SUSAN E (MA, CCC-A)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 ALEXANDER HALL
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-3340
Mailing Address - Country:US
Mailing Address - Phone:270-809-6821
Mailing Address - Fax:
Practice Address - Street 1:125 ALEXANDER HALL
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-3340
Practice Address - Country:US
Practice Address - Phone:270-809-6821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0301231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist