Provider Demographics
NPI:1760871164
Name:BAKER, SUSAN (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BAKER
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 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 21ST AVENUE SOUTH, SUITE 6209
Practice Address - Street 2:VUMC MCE, SOUTH TOWER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8718
Practice Address - Country:US
Practice Address - Phone:615-936-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist