Provider Demographics
NPI:1790128445
Name:FORBES-FROST, SUSAN CATHERINE (MS-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CATHERINE
Last Name:FORBES-FROST
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 1:639 BUCKROE DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-7284
Mailing Address - Country:US
Mailing Address - Phone:910-603-4390
Mailing Address - Fax:
Practice Address - Street 1:639 BUCKROE DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-7284
Practice Address - Country:US
Practice Address - Phone:910-603-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist