Provider Demographics
NPI:1689823734
Name:NORMAN, SUSAN COUSE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:COUSE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALBIE DR
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-2301
Mailing Address - Country:US
Mailing Address - Phone:845-229-8717
Mailing Address - Fax:
Practice Address - Street 1:15 ALBIE DR
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-2301
Practice Address - Country:US
Practice Address - Phone:845-229-8717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-13
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008084-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist