Provider Demographics
NPI:1184736472
Name:WEBER, SUSAN E (SLP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:WEBER
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 1:13642 N HIGHWAY 183
Mailing Address - Street 2:BLDG. 2, STE. 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2265
Mailing Address - Country:US
Mailing Address - Phone:512-331-4115
Mailing Address - Fax:512-331-8176
Practice Address - Street 1:13642 N HIGHWAY 183
Practice Address - Street 2:BLDG. 2, STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2265
Practice Address - Country:US
Practice Address - Phone:512-331-4115
Practice Address - Fax:512-331-8176
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist