Provider Demographics
NPI:1629221544
Name:COMBS, SUSAN WRIGHT (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:WRIGHT
Last Name:COMBS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 SMALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29130-7337
Mailing Address - Country:US
Mailing Address - Phone:803-553-0813
Mailing Address - Fax:
Practice Address - Street 1:1858 SMALLWOOD RD
Practice Address - Street 2:
Practice Address - City:RIDGEWAY
Practice Address - State:SC
Practice Address - Zip Code:29130-7337
Practice Address - Country:US
Practice Address - Phone:803-553-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist