Provider Demographics
NPI:1659494219
Name:VAVROCK, SUE ABEL (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:ABEL
Last Name:VAVROCK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 GATEWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2589
Mailing Address - Country:US
Mailing Address - Phone:615-848-9265
Mailing Address - Fax:615-225-0677
Practice Address - Street 1:1370 GATEWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2589
Practice Address - Country:US
Practice Address - Phone:615-848-9265
Practice Address - Fax:615-225-0677
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1445231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist