Provider Demographics
NPI:1629365481
Name:PALLADINO, SUSAN D (MA,CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:D
Last Name:PALLADINO
Suffix:
Gender:F
Credentials:MA,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OXFORD DR STE 10
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1837
Mailing Address - Country:US
Mailing Address - Phone:412-692-3440
Mailing Address - Fax:412-851-1750
Practice Address - Street 1:1500 OXFORD DR STE 10
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1837
Practice Address - Country:US
Practice Address - Phone:412-692-3440
Practice Address - Fax:412-851-1750
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002484L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist