Provider Demographics
NPI:1558500082
Name:VOSS, SUZZANE PATRICIA (CCC-SLP-L)
Entity type:Individual
Prefix:MRS
First Name:SUZZANE
Middle Name:PATRICIA
Last Name:VOSS
Suffix:
Gender:F
Credentials:CCC-SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-2005
Mailing Address - Country:US
Mailing Address - Phone:716-672-4397
Mailing Address - Fax:
Practice Address - Street 1:197 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-2005
Practice Address - Country:US
Practice Address - Phone:716-672-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007489-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist