Provider Demographics
NPI:1700490539
Name:SUITER, DEVON (AUD)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:SUITER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3341
Mailing Address - Country:US
Mailing Address - Phone:410-535-6975
Mailing Address - Fax:
Practice Address - Street 1:4000 MITCHELLVILLE RD STE A414
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3142
Practice Address - Country:US
Practice Address - Phone:301-860-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01535231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist