Provider Demographics
NPI:1265809545
Name:GORDON-HICKEY, SUSAN (AUD, PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:GORDON-HICKEY
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:GORDON
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, PHD
Mailing Address - Street 1:PO BOX 40277
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0277
Mailing Address - Country:US
Mailing Address - Phone:251-445-9378
Mailing Address - Fax:251-445-9377
Practice Address - Street 1:5721 USA DR N RM 1119
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36688-0002
Practice Address - Country:US
Practice Address - Phone:251-445-9378
Practice Address - Fax:251-445-9377
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1012A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist