Provider Demographics
NPI:1770749277
Name:ENGLE, SUZANNE (MS,CCC-SLP/L)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:ENGLE
Suffix:
Gender:F
Credentials:MS,CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 EDGEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3004
Mailing Address - Country:US
Mailing Address - Phone:585-721-1210
Mailing Address - Fax:315-331-3215
Practice Address - Street 1:848 PEIRSON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-9762
Practice Address - Country:US
Practice Address - Phone:315-331-2086
Practice Address - Fax:315-331-3215
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007637-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist