Provider Demographics
NPI:1295081842
Name:HANCE, SUSAN E (MS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:HANCE
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 1:4204 THURSLEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-8201
Mailing Address - Country:US
Mailing Address - Phone:910-512-0704
Mailing Address - Fax:910-452-3665
Practice Address - Street 1:1402 HOSPITAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6659
Practice Address - Country:US
Practice Address - Phone:910-210-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2658235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist