Provider Demographics
NPI:1710086103
Name:CANTELE, SUSAN M (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:M
Last Name:CANTELE
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 E CLUBSIDE CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-4036
Mailing Address - Country:US
Mailing Address - Phone:316-636-2694
Mailing Address - Fax:316-681-0994
Practice Address - Street 1:8823 E CLUBSIDE CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-4036
Practice Address - Country:US
Practice Address - Phone:316-636-2694
Practice Address - Fax:316-681-0994
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist