Provider Demographics
NPI:1881977262
Name:COUTS, SUSANNAH CARLISLE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:CARLISLE
Last Name:COUTS
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 1:1009 WOOD DUCK CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4028
Mailing Address - Country:US
Mailing Address - Phone:615-428-7604
Mailing Address - Fax:
Practice Address - Street 1:1009 WOOD DUCK CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-4028
Practice Address - Country:US
Practice Address - Phone:615-428-7604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist