Provider Demographics
NPI:1649589235
Name:ATCHISON, SUSAN ALICE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ALICE
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ALICE
Other - Last Name:CAPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2070 NORTHBROOK BLVD STE B4
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9254
Mailing Address - Country:US
Mailing Address - Phone:843-569-3033
Mailing Address - Fax:843-569-4535
Practice Address - Street 1:2070 NORTHBROOK BLVD STE B4
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9254
Practice Address - Country:US
Practice Address - Phone:843-569-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7412235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist