Individual provider · NPI-1

Susan Coon

Speech-Language Pathologist, · Saint Clair Shores, MI

NPI number1811565245
StatusActive
Last updated in NPPESJun 13, 2021

Details

NPI
1811565245
Entity type
Individual (NPI-1)
Name
Susan Coon
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 13, 2021
Certification date
Jun 13, 2021
Last updated
Jun 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,7101002323MIYes

Practice location

19631 Ridgemont St
Saint Clair Shores, MI 48080-3320

Phone 248-705-6027

Mailing address

19631 Ridgemont St
Saint Clair Shores, MI 48080-3320

Phone 248-705-6027

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