Provider Demographics
NPI:1811416498
Name:KIRKLAND, SUSAN M (SLPA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 JACKSON DR NE
Mailing Address - Street 2:
Mailing Address - City:RESACA
Mailing Address - State:GA
Mailing Address - Zip Code:30735-6477
Mailing Address - Country:US
Mailing Address - Phone:706-307-0919
Mailing Address - Fax:
Practice Address - Street 1:165 JACKSON DR
Practice Address - Street 2:
Practice Address - City:RESACA
Practice Address - State:GA
Practice Address - Zip Code:30735
Practice Address - Country:US
Practice Address - Phone:706-307-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant