Provider Demographics
NPI:1811261100
Name:MEISER, SUSAN PROFFITT (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:PROFFITT
Last Name:MEISER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 MAPLE TREE CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1157
Mailing Address - Country:US
Mailing Address - Phone:513-404-8860
Mailing Address - Fax:
Practice Address - Street 1:2618 MAPLE TREE CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1157
Practice Address - Country:US
Practice Address - Phone:513-404-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-04
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4428235Z00000X
KY3833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist