Provider Demographics
NPI:1669777165
Name:BROWN, SUSAN SIMS (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:SIMS
Last Name:BROWN
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 1:829 LEGENDARY LN
Mailing Address - Street 2:
Mailing Address - City:GUN BARREL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75156-4315
Mailing Address - Country:US
Mailing Address - Phone:903-388-1971
Mailing Address - Fax:903-887-9063
Practice Address - Street 1:829 LEGENDARY LN
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-4315
Practice Address - Country:US
Practice Address - Phone:903-388-1971
Practice Address - Fax:903-887-9063
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist