Provider Demographics
NPI:1932384864
Name:LANG, SUSAN ELIZABETH (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:LANG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 EUGENE ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-3917
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:716-662-5700
Practice Address - Street 1:6167 W QUAKER ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2640
Practice Address - Country:US
Practice Address - Phone:716-662-4800
Practice Address - Fax:716-662-5700
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013970-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist