Provider Demographics
NPI:1952581662
Name:HAMALAINEN, SUSAN WHITTY (MED, CCC-SLP, CEIS)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:WHITTY
Last Name:HAMALAINEN
Suffix:
Gender:F
Credentials:MED, CCC-SLP, CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1827
Mailing Address - Country:US
Mailing Address - Phone:978-436-9405
Mailing Address - Fax:
Practice Address - Street 1:35 RIVER ST
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-1827
Practice Address - Country:US
Practice Address - Phone:978-436-9405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA00140616OtherASHA
MA600OtherMASS LICENSURE