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Individual
REBECCA SUSAG
Active
Individual
REBECCA SUSAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2418
WI
235Z00000X
Speech-Language Pathologist
Primary
5443
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068R8SU
BCBS
MN
01
—
093K5SU
BCBS
MN
01
—
4600096
MEDICA
MN
01
—
HP45890
HEALTH PARTNERS
MN
Enumeration date
10/19/2006
Last updated
07/09/2007
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