Provider Demographics
NPI:1740487396
Name:HOWELL, SUSAN MARY (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:HOWELL
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 961205
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-1205
Mailing Address - Country:US
Mailing Address - Phone:817-740-8400
Mailing Address - Fax:817-433-5352
Practice Address - Street 1:6100 HARRIS PARKWAY,
Practice Address - Street 2:SUITE 350
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132
Practice Address - Country:US
Practice Address - Phone:817-433-5350
Practice Address - Fax:817-433-5352
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50160231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00660209OtherRAILROAD MEDICARE