Provider Demographics
NPI:1740505338
Name:HERRIFORD, SUSAN M (SLP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:HERRIFORD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 AVENUE D
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-252-9600
Mailing Address - Fax:406-252-0595
Practice Address - Street 1:1537 AVENUE D
Practice Address - Street 2:SUITE 210
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-252-9600
Practice Address - Fax:406-252-0595
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist