Provider Demographics
NPI:1629219647
Name:HORWITZ, SUSAN B (MA,CCC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:HORWITZ
Suffix:
Gender:F
Credentials:MA,CCC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:LYNN
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC
Mailing Address - Street 1:111 ELM ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1967
Mailing Address - Country:US
Mailing Address - Phone:508-799-6278
Mailing Address - Fax:508-829-5092
Practice Address - Street 1:111 ELM ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1967
Practice Address - Country:US
Practice Address - Phone:508-799-6278
Practice Address - Fax:508-829-5092
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASL 83235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist