Provider Demographics
NPI:1700631223
Name:TITUS ISRAELS, SUZANNE WILLEMIJN (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:WILLEMIJN
Last Name:TITUS ISRAELS
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 1:1011 EUGENE ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1415
Mailing Address - Country:US
Mailing Address - Phone:541-354-1691
Mailing Address - Fax:
Practice Address - Street 1:3686 DAVIS DR
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9306
Practice Address - Country:US
Practice Address - Phone:541-354-1691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist