Provider Demographics
NPI:1831386408
Name:TOTH, SUSAN A (CCC-A/SLP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:TOTH
Suffix:
Gender:F
Credentials:CCC-A/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEARING CONSERVATION PROGRAM
Mailing Address - Street 2:U OF MT, 634 EDDY AVE.
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59812-1851
Mailing Address - Country:US
Mailing Address - Phone:406-243-5767
Mailing Address - Fax:406-243-4730
Practice Address - Street 1:HEARING CONSERVATION PROGRAM
Practice Address - Street 2:U OF MT, 634 EDDY AVE.
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59812-1851
Practice Address - Country:US
Practice Address - Phone:406-243-5767
Practice Address - Fax:406-243-4730
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT363231H00000X
MT284231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT534937Medicaid
MT5605821Medicaid