Provider Demographics
NPI:1689845844
Name:STAMM, SUSAN MARIE (MSCCC/A)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:STAMM
Suffix:
Gender:F
Credentials:MSCCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2423
Mailing Address - Country:US
Mailing Address - Phone:419-424-1393
Mailing Address - Fax:419-424-3424
Practice Address - Street 1:1110 W MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-2423
Practice Address - Country:US
Practice Address - Phone:419-424-1393
Practice Address - Fax:419-424-3424
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01059231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist