Provider Demographics
NPI:1922178144
Name:BOSLER, SUZANNE MARIE (MACCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARIE
Last Name:BOSLER
Suffix:
Gender:F
Credentials:MACCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 WEST PANTHER CREEK
Mailing Address - Street 2:SUITE 206
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381
Mailing Address - Country:US
Mailing Address - Phone:281-681-3020
Mailing Address - Fax:281-298-9905
Practice Address - Street 1:4840 WEST PANTHER CREEK
Practice Address - Street 2:SUITE 206
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381
Practice Address - Country:US
Practice Address - Phone:281-681-3020
Practice Address - Fax:281-298-9905
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist