Provider Demographics
NPI:1558637488
Name:NERHEIM, SUSAN L (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:NERHEIM
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:ROTHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:13850 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2828
Practice Address - Country:US
Practice Address - Phone:480-415-6994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSP0058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist