Provider Demographics
NPI:1811128937
Name:BOOK, SUSAN FIEDLS (CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:FIEDLS
Last Name:BOOK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:OH
Mailing Address - Zip Code:44875-1412
Mailing Address - Country:US
Mailing Address - Phone:419-347-1503
Mailing Address - Fax:419-347-1503
Practice Address - Street 1:225 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-1412
Practice Address - Country:US
Practice Address - Phone:419-347-1503
Practice Address - Fax:419-347-1503
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.9037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist