Provider Demographics
NPI:1992006118
Name:HAAS, SUSAN ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:HAAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:ELIZABETH HAAS
Other - Last Name:WURTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:40 GLANN ROAD
Mailing Address - Street 2:TIOGA HILLS ELEMENTARY SCHOOL
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 GLANN ROAD
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732
Practice Address - Country:US
Practice Address - Phone:607-757-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012921235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist