Provider Demographics
NPI:1457337677
Name:MCLAUGHLIN, SUSAN K (AUD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:K
Other - Last Name:FRICKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:380 E BAYFRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-2408
Mailing Address - Country:US
Mailing Address - Phone:814-877-9060
Mailing Address - Fax:814-877-9089
Practice Address - Street 1:380 E BAYFRONT PKWY
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-2408
Practice Address - Country:US
Practice Address - Phone:814-877-9060
Practice Address - Fax:814-877-9089
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006064231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200401630Medicaid