Provider Demographics
NPI:1942599907
Name:WESTMORELAND, SUSAN DAWN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DAWN
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 N DONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2728
Mailing Address - Country:US
Mailing Address - Phone:405-234-7534
Mailing Address - Fax:
Practice Address - Street 1:1245 WHIPPOORWILL VISTA
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-7029
Practice Address - Country:US
Practice Address - Phone:405-769-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist