Provider Demographics
NPI:1851565121
Name:WEBB, SUSAN BIVENS (MA -CCC-A)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:BIVENS
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA -CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 OAK RIDGE TURNPIKE
Mailing Address - Street 2:SUITE C-100
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830
Mailing Address - Country:US
Mailing Address - Phone:865-483-2288
Mailing Address - Fax:865-483-6568
Practice Address - Street 1:800 OAK RIDGE TURNPIKE
Practice Address - Street 2:SUITE C-100
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-483-2288
Practice Address - Fax:865-483-6568
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA 0000001150231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist