Provider Demographics
NPI:1760735666
Name:SCHICK, SUSANN TATTINI (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUSANN
Middle Name:TATTINI
Last Name:SCHICK
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 1:3444 FAIRESTA ST
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1836
Mailing Address - Country:US
Mailing Address - Phone:818-388-5298
Mailing Address - Fax:
Practice Address - Street 1:3444 FAIRESTA ST
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-1836
Practice Address - Country:US
Practice Address - Phone:818-388-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13105235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist