Provider Demographics
NPI:1528381324
Name:KIMELMAN, SUSAN SHAIMAN (PHD)
Entity Type:Individual
Prefix:PROF
First Name:SUSAN
Middle Name:SHAIMAN
Last Name:KIMELMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ATWOOD ST
Mailing Address - Street 2:DEPT. COMM. SCI & DIS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15260
Mailing Address - Country:US
Mailing Address - Phone:412-383-6545
Mailing Address - Fax:412-383-6555
Practice Address - Street 1:233 ANITA AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217
Practice Address - Country:US
Practice Address - Phone:412-383-6545
Practice Address - Fax:412-383-6555
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004956L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist