Provider Demographics
NPI:1912035601
Name:CARUSO, PATRICIA SUZANNE (SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUZANNE
Last Name:CARUSO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10615 CALICO LN
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8716
Mailing Address - Country:US
Mailing Address - Phone:440-285-7762
Mailing Address - Fax:
Practice Address - Street 1:14800 PRIVATE DR
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3553
Practice Address - Country:US
Practice Address - Phone:216-761-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP3049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist