Provider Demographics
NPI:1932775772
Name:HALPERN, SUSANNAH LIN (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:LIN
Last Name:HALPERN
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:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:NH
Mailing Address - Zip Code:03836-0303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 PINE HILL RD.
Practice Address - Street 2:
Practice Address - City:WOLFEBORO FALLS
Practice Address - State:NH
Practice Address - Zip Code:03896
Practice Address - Country:US
Practice Address - Phone:603-569-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist