Provider Demographics
NPI:1205065232
Name:GRESLE, SUZANNE ORR (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:ORR
Last Name:GRESLE
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 9-4400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-686-5475
Mailing Address - Fax:404-686-4699
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 9-4400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-686-5475
Practice Address - Fax:404-686-4699
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist