Provider Demographics
NPI:1871688069
Name:GINTER, SUZANNE RENE (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:RENE
Last Name:GINTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-5004
Mailing Address - Country:US
Mailing Address - Phone:574-533-2222
Mailing Address - Fax:574-533-6868
Practice Address - Street 1:2134 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-5004
Practice Address - Country:US
Practice Address - Phone:574-533-2222
Practice Address - Fax:574-533-6868
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002190A231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200668300OtherFIRST STEPS EDS
1871688069OtherSUZANNE GINTER PERSONAL NPI
IN256980AOtherMEDIARE PTAN
IN1356512974OtherFAMILY HEARING CENTER, INC. GROUP NPI
IN200534540Medicaid