Provider Demographics
NPI:1265863005
Name:JONES, SUZANNE DENISE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 SHAMROCK DR
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57033-2396
Mailing Address - Country:US
Mailing Address - Phone:719-660-8507
Mailing Address - Fax:
Practice Address - Street 1:704 SHAMROCK DR
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:SD
Practice Address - Zip Code:57033-2396
Practice Address - Country:US
Practice Address - Phone:719-660-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD302-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist