Provider Demographics
NPI:1124149984
Name:CRIPPS, SUSAN BISHOP (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:BISHOP
Last Name:CRIPPS
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 1:102 TYRON RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-7556
Mailing Address - Country:US
Mailing Address - Phone:843-873-5684
Mailing Address - Fax:
Practice Address - Street 1:9995 MILES-JAMISON ROAD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-821-5818
Practice Address - Fax:843-821-5800
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist